HomeMy WebLinkAboutPermit Renewals SINNING AND DEVELOPME i-,ni7ICES DEPARTMENT
"I BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1-7C) do3"1 ADDRESS: A v e
I Peter'A Cafaro III ,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 tJktp 64t-j v%Ek A- AAROwA+E
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OWNER/,13R OR CONTRACTOR SI DATE
i
Peter A C faro I I I
Print Name
STATE OF FLORIDA
COUNTY!OF GRANGE
ACKNOWLEDGED BEFORE ME THIS I P' DAY OF VVOwC_t -, .20
I
BY Peter A Cafar o III WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STA . F FL,ORI A. ounty of 0 nge 4
�� NotaryPubommilicStateotFlorida t
. Kari M Riccaboni e.
SIG 1R S Ljs�flpe�t �ypC s05128 020981647 <
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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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