HomeMy WebLinkAboutPermit Renewals Mar 2119,09:13a Advantage Air 7724654946 p•1
PLANNING AND DEVELOPNIENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
Los sigm 5300 VIRGINIA AVE
FORT PIERCE,FL 349k, RECEIVED
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUE T MAR 2 1 2Q19
7 Lucie County, Permitting
PERMITNUMBER: 1808-0424/714 ADDRESS:207 MANGROVE BAY PL
I SAMUEL T. DURHAM 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 PERMIT EXPIRED
OWNERrBLDR OR CONTRACTOR SIGNATURE
SAMUEL T. DURHAM
Print Name
STATE Ofi FLORIDA
COUNTY OF ST.LUCIE ,
ACKNOWLEDGED BEFORE ME THIS 19TH DAY OF MARCH ,2019
BY SAMUEL T. DURHAM WHO IS PERSONALLY.KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,Co ty of ST. LUCIE s t XAIW SMR
MYOOMMISSIONI:FF898018
*ow
EXPIRES;July12,2019
SIGNATURE NOTARY r SogpryacuBuQletNa>azyStes
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 = S Renewal fee
Example: [15 divided by 23=.65(%)] $175(permitfee)x,.65=$113.75(renewal fee)
Revisal 71214'2014