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
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1807-0753 ADDRESS: 9550 S Ocean Drive
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
OWNERJ419LDR OR CONTRACTOR SIGNATURE DATE
matthew kuntz
Print Name
STATE OF FLORIDA
COUNTY OF st lude
ACKNOWLEDGED BEFORE ME THIS 18 DAY OF february 12019
BY matthew kuntz WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STATEFLO DA, ty St IUCIe
OF NOTARY Y°6a;
DIANE C WALKER
SIGN
ko MY COMMISSION#FF967913
n;' EXPIRES:MAR 06,2020
Bonded through 1st State Insurance
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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
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