HomeMy WebLinkAboutPermit Renewal (2) , ' ,r` 415A
LANNING AND DEVELOPMENT SERVICES DEPARTMENT QIT
rD tom
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
RFrFf frE®
PERMIT RENEWAL REQUEST per NOV 2 ?418
nllttin
St411007 ent
PERMIT NUMBER: 1-7W-0476o ADDRESS: Ca'i �t\l�.Q C- :•
�c.ij4
I Peter A Cafaro III ,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 -tr, 6(LR ,Q' Ft in ie -1e
Ji ,2i2c/fr
OWNE BLDR OR CON "AC' •• ,IGNATURE D TE
Peter A Cafaro III
Print ane
STATE 0 FLORIDA
COUN OF ORANGE
ll
ACKNOWLEDGED BEFORE ME THIS 2 G DAY OF JAO V, ,20 I
BY PETER A CAFARO III WHO IS PERSONALLY KNOWN TO ME X ,OR
HAS PROVIDED AS IDENTIFICATION.
ST E0_ U RIDA,County of O"ANGE
'w
Notary Public State of Florida
Kari M Riccaboni
//SI NATE RL O N t� RY SEAL My Commission FF 981647 <`
+. Expires 05,2812020
Ot A
__ _____- ' ---------------I------------__�'-_-__-----------------'-__� � _�� ------_-'-___"_-
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(pennit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014