HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST NOV 0 5 2018
ST. Lucie County, Pgrmitting
PERMIT NUMBER: 1 :�D6- OIt-W ADDRESS: �64DO. 'A'JI NVI
I, r1�IS ZOt(' K , 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
Degkb 1-141
1 �1�5
OWNER/131,29 OR CONTRACTOR SIGNATURE DATE
i e%5 2Aw
Print Name
STATE OF FLORID
COUNTY OF`'�(LQ
ild
ACKNOWLEDGED BEFORE ME THIS AY OF IQQ&jMbff ,20J&
BY D 06 nac� WHO IS PERSONALLY KNOWN TO ME 1/ ,OR
HAS PROVIDED' '' 11 AS IDENTIFICATION.
%GNATURE
FLORID o f �. WcAe
ftv `` ;. COLEEN SULLIVAN
OF ARY SEAL '*= 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
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