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AN
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
7:72' jrc
COUNTY
BUILDING AND CODE REGULATIONS DIVISION
FLORIDA - 2300 VIRGINIA AVE RECEIVED
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 MAR 0'6
1018
Permitting Department
PERMIT RENEWAL REQUEST St.Lucie County
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PERMIT NUMBER: 1806-0828 ADDRESS: 509 Myrtle Drive
1, Toby Tokes ,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 There were a few service items that needed to be completed prior to the final inspection
being scheduled.Those items have since been addressed and the work is ready for inspection.
02/27/2019
`
O :I,tilt O' ONTRACTOR SIGNATURE DATE
oby Tokes
Print Name
STATE OF FLORIDA
COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS 27 DAY OF FEBRUARY 2019
BY TOBY TOKES WHO IS PERSONALLY KNOWN TO ME X ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of PALM BEACH
,xpLe-t w ��of•ty, Victoria Lee Murrell
SIIGNATURE OFI�OTARY oQ _NOTARY PUBLIC
F � ° TE OF FLORIDA
.+- �t-s?Comm#GG240913
INCE 1-4 Expires 11/18/2022
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