HomeMy WebLinkAboutPermit Renewals (2) 7727949783 ARS 08:25:44 p.m. 02-11-2019 112
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34992
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST FEB 12 2019
9T: 6H@I@�§Wfftyj rf-s fffil t'1
PERMIT NUMBER: ADDRESS:4(b Ca ')P ( 0,00s,
I, O�NkS 7-Groy— am requesting that the above permit be renewed. I
understand that 1 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
I
O L 1 M, O TRAC OR SIGNATURE DATE
Print Name-
STATE'OF FLORIDA
COUNTY OF_:5Ord?_
ACKNOWLEDGED BEFORE ME THIS DAY OF
BY WjjAg���. OR
IS ERSONALLY KNOWN TO
HA PRO IDED AS IDENTIFICATION.
COLEEN SULLIVAN
C f oek My COMMISSION N GG071535
EXPIRES February 09,2021
S N O TA Y SEA
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage: Renewal fee
Original permit fee* x%open = $
Example: [15 divided by 23=.65(1/1n)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014