HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
I
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1807-0752 ADDRESS: 5300 Melville Road
I, Matthew Kuntz , 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 schedule final inspection
2/18/2019
OWNER/BLDK OR CONTRACTOR SIGNATURE DATE
matthew kuntz
Print Name
STATE OF FLORIDA
COUNTY OF st lude
ACKNOWLEDGED BEFORE ME THIS 18 DAY OF febt nary 2019
BY matthew kuntz WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED - AS IDENTIFICATION.
STATE OF F ORI ,Coun of St I Cle
O,�pgV PpB DIANE C WALKER
;?� `� MY CJM�ASSSiOP!#FF967913
EXPIRES:MAR 09,2020
SIG NOT � -, ad through 1 st State Insurance
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
i
I
I