Loading...
HomeMy WebLinkAboutPermit Renewals 1 rr , 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 / Q a PERMIT NUMBER: L O /q 0<4� ADDRESS: g100 /� t�1 l l' I, ,am requesting that the above permit be renewed. I j 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 3 Aa:-- O LDR OR CONT TOR SIGNATURE ATE IPrint Name STATE OF FLORI A COUNTY OF 1 ACKNOWLEDGED BEFORE ME THIS DAY OF t)A 20 l� BY WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED AS IDENTIFICATION. r TE OF FLORI A,Cou9n�of �- �1'I'A ,s IASHAHNAINGRAM-RAHMING 1;= MY COMMISSION#GG 275060 ATURE OF NO Yo`.' ©(FIRES:D�6.wOb6►�'10,2022 Pio`` 8011 YU� N ePUb9C III1dC1V11116rS I FOR OFFICE USE ONLY: i 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 -r. »Jw x:,^`•.,F srt:,'fNn _:.�N.dSx_d.*1^_r,A,: Ain: _ - :+{V C�i�:YBi iiiC.•if�4i��a:�.�.r',F�.i-t a�t'c,'_�.. `.Y�Y;,;;�=,�{'j l�j '.�;}isle:i�t��iY��J��r.l`.^ii: �!�1�,,1 ,+�'x 4i:ty� :1"' �� ti 'S' P:.�rr _ �a:2. .. ..-ter.... �.�.._._.5a._y_. ,...:4'..�,(:lf.t. ..:'1'i.-.