HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
NMj7jT �1,
o i BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
MAR 2 9 2019
PERMIT RENEWAL REQUEST ST Lucie county, Permitting
PERMIT NUMBER: 1808-0119 ADDRESS: 10208 S. INDIAN RIVER DR.
I, ROBERT LUDLUM ,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 Client was out of town
3/19/19
C RACTOR SIGNATURE DATE
Rob udlum
Print Name
STATE OF FLORIDA
COUNTY OF st lude county
ACKNOWL'EDGED-BEFORE ME THIS 19 DAY OF March 2019
BY Lesll Graham _ WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE O7FF Cou o Ducie County
00/fit+ Notary Public State of:Florida
;Q �D GrahamF OTmmission GG 22
�'oi� Expires 01/30/2023
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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