HomeMy WebLinkAboutPermit Renewals 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 MAY 17 2019
ST. Lucie County, Permitting
PERMITNUMBER: ADDRESS: ILff_a 1=T f-21BZ -.,I3`-Pq'5�
I, CA-,2a (.0(lr S-.tJ ,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 Py Sh&i '1�1D`-T ( � T (.UAS UNDE1211IF flSsvi'`(P-11 60
Tit 1-r HVO e(P, p
lig
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
Print Name
STATE OF FLORIDA
COUNTY OF ! C , �-'l c\4-*, `
ACKNOWLEDGED BEFORE ME THIS 11 DAY OF 20_ft_
BY C-0,A d\ W• WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
TATE OF FLORIDA,County of S 31 .L J e :� �oi DEANNAPrIARIE GIVENS
MY COMM:D,, #r 1 ,20203
EXPIRES:December 16,2020
'K Bonded Thru Notary Public Underwriters
SIGNATURE OF NOT � '�•
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