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03/28/2019 11:54AM 7726172381 HPlastering&Stucco PAGE 01/02
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
® ` BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST MAR B 8 2019
ST. Lucie County, Permitting
PERMIT NUM3ER: ADDRESS: Q. R I R —
1, w 1c6u S ,am xequestiug that the above permit be renewed. I
understand that Pmust s hedule and pass all required inspections for the permit to be fanaled. 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.
Justt£icatio � } lid C� Ltg�C�ttT �tc b� LR 11.Y�1z�. .
OWNER/BLDR QR CON RA OR GNA, URE DATE
Priut Name
STA'T'E OF FLORIDA..
COUNTY OF mh �4m
ACKNOWLEDGED BEFORE ME THIS DAY OF QVLt .20—s--
)BY ,R � � �� WHO IS PERSONALLY KNOWN TO MEJ OR
HAS PROVIDED AS IDI�IFICA,TION_
STATE OF FLORIDA,Co ty.of C H E U.I A FA R I S
C,YALR�a '~State of Florida-Notary Public
• Commission#GG 262237
SfC-111ATqRE OF NOTAR4f My Commission Expires
January 01, 2023
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections;
(Divide opera by total to get%of open ivaspections)
Percentage:
Original permit fee: x%open = $a:�_Rncwal fee
Example- [15 divided by 23=.65(%)] S175(permit fee)x.65$113.75(renewal fee)
Revised 712V2014