HomeMy WebLinkAboutRenewal (3rd request approved) 'Jan 1019 03:0ep Fence Depot 7728788283 p.1
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PLANNING AND DEVELOPMENT SERVICES DErARTIKENT
COUNTY .' BUILDING AND CODE REGULATIONS DIVISION / •'
r I (1 ri i r ... •-• z300 VIKONTA AVE
• , •— . ______ ' FORT PIERCE,FL.34982 MI
p.m 42-1553 Fox(772)42457w ,e.„, •-ij CS\
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PERMIT RENEWAL REQUEST /
PERMIT NUMBER:joi.-- 0v4i 3 ADDRESS: 5 .cieleiviiel vejr .
1, Sc 0 1-"F f-e.r--e/:,.5: _,am requesting that the above permit be renewed, X
understand that I must schedule arid pass all required inspections for the permit to be finale& Further,I
understand that this is a ONE TIME RIZELW4T4 and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification I : .L. _ « a• , 6
.. / .fl....:1.Millini 1 ' " ; " • 141MINIMIOMIlir a. • ,'"°1:
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0 ' :LDR Qs CONTRACTOR SIGNATURE ' DATE
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Print Name
STATE DF FLORLTA
COUNTY'OF .,Si- .1--%.5 C i',-(
ADKNOWLEDOED114F0111 ME TIES i Cl DAY OF J-6.„i cD.,
BY •S..'C*•:. _ 471 ,--f WHO IS l'ERSONALLy KNOWN 70/1.4E 1---------7,OR
.HAS PROVIDED AS IDEN7FICATION.
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••• STE OF FLORID County of (5 c , . ,', 0, ,. CATHY J!MEETS 111
11.1 Q.A4....ks. i ,_.______—.
e .1; Notary PulfliO-State of Florida 11
i.C?;;'f'..;:‘..\:q CoremIsn Ion t.•IT 221708 !!:
SII3NATURB • °YAW( Abi,L,...:.,„.:.t;;4 My Comm.E.A9ints May 1C',201'3
Borall Inroi:1-,.`i Nat!ond h!,1;:;7:..:•:.:. ' .
• •.....0111. . ----.' • i•m• .•.•••••••----. .m. ...m.••••••..... .•111......•1461 .
FOR OFF1Ct USE ONLY:
Number of Oper.Inspections: .
.. Total iespeetiorls:
(Divide open by total to get%of open iliiiection)
Percentage:
Originatpermi.1 fee: x%open - S Renewal fee
Exam.p1c: C1.5 divided by 23-45 WO] 5175(perrnit fcc)lc 45—S113,75(renewal fee)
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itaviyed 7/2112014 .
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