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: 1808-0364#197 ADDRESS: 3093 N. Dixie Hwy Fort Pierce, FL 34946
I, Raquel Swanner ,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 We ran into problems with ordering preventing the work from being completed.
befo ermit expires.
�9
a
ACTOR SIGNATURE DATE
aquel Swanner
Print Name
STATE OF FLORIDA
COUNTY OF 3 k. LUG1 P i
ACKNOWLEDGED 1BEFORE ME THIS `1 DAY OF 20 la
BY 04 a(I fl L� WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED C 1 AS IDENTIFICATION.
STATE OFF 0 A,County of CJ t. Lucie -,.,, i s,i fey RaMe3
NOTARY P!lBL1C
�STATE OF.FLORtDA
SIGNATURE O'FItOTARY SEAL 'l Comm#GG235648
Expires 71512022
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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)
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Revised 7/21/2014