HomeMy WebLinkAboutMisc Letters PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
COUNTY BUILDING AND CODE REGULATIONS DIVISION
• R I D A 2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: / tQ J- p ADDRESS:
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
OWNS LDR OR CONTRACTOR SIGNATURE DATE
Print Name
STATE OF FLORIDA
COUNTY OF 4ttjCo4a-�
ACKNOWLEDGED BEFORE ME THIS _'?' (�DAY OF 9 ,201
BY Y) WHO IS PERS ALL TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of Y'P AUDREY B.HUMPHREY
..va
MY COMMISSION#FF 174772
*` EXPIRES:March 6,2019
SIGNA 0 OT - SEAL %?;pQ Bonded Thru Notary Public Undarwriters
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FOR OFFICE USE ONLY: CEPHED
RE
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections) JAN 2 4 2019
Percentage:
Original permit fee: x%open = $ Renewal fee Permitting Department
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee) St. Lucie County, FL
Revised 7/21/2014