HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
— - - - FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
NOV 0 5 2018
PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
PERMIT NUMBER: lJ � ADDRESS: J O -o
I, n�115 Zitc el<, ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
O"ER/BLQV OR CONTRACTOR SIGNATURE AT
I MA15 Zacei;
Print Name
STATE OF FLORID
COUNTY OF 5+. (�,�)P �d
ACKNOWLEDGED BEFORE ME THIS QnAY OF � 20—&
BY Q)1 6 rm&t WHO IS PERSONALLY KNOWN TO ME � ,OR
HAS PROVIDED AS IDENTIFICATION.
%GNATURE
FLORID o f ��, LUC�
`Z COLEEN SULLIVAN
�0. `ni
OF ARY g Q: MY COMMISSION#GG071535
EXPIRES February 09,2021
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage: -
Original permit fee: x%open = $ ,_Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014