HomeMy WebLinkAboutPermit Renewal ® S
_iMINNIRMIENMES PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
9..,E 6 .
Cdaa<iNT<Y
: BUILDING AND CODE REGULATIONS DIVISION
F L o It 1 D A " 2300 VIRGINIA AVE RECeiveo
INEMENNINNIEW FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 DEC 2 Z 2018
permittin
PERMIT RENEWAL REQUEST St,Luce Cain gent
PERMIT NUMBER: 1806-0018 ADDRESS: 301 Essex Dr. Fort Pierce, FL, 34946 ,
I Raquel Swanner ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be fmaled. 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 The inspections were not completed and we need this permit active so a final inspection
can .- --•-duled and completed.
i
......Ap
so//.0 ,
OWNE' : ID:.17'7' RACTOR SIGNATURE DA
Rare -el Swanner
Print Name
STATE OF FLORIDA
COUNTY OF S) Luc 1 2.
ACKNOWLEDGED BEFORE ME THIS ZD DAY OF t)eceMj-2(2._ ,20
BY I AQU-eL 9.4)Ah'1"'L2 WHO IS RSONALLY KNO TO ME .OR
HAS PROVIDED AS IDENTIFICATION. '
I
Richie Roberts
..
ST, ' OF FL') of 5T- LUCI`e_ C NOTARY PUBLIC
.STATE OF FLORIDA
SIGN OF TARY SEAL Expires 6/4/2020
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