HomeMy WebLinkAboutRevisions 06/07/2019 11:39 7726921094 PREMIER PAGE 02/03
PLANNING AND DEVIELOPA11M SERVICES DEPARTMENT
BuumING AND COME REGULATIONS DWISION
ZW g arrMAAVE
FORT PMRlCE,FL 34982
('172)462-15S Fag(7M 462-1$78
RECEIVED."
ERAffr RE. WAL REQUEST
JUN 0.7 2819
SST. Lucie County, Permitting /,Q
1>F_R&1I� ER: /o - a DRFss: !J s c � 1/LfPL
T?Vesting.that the ahoVe permit be renewed. I
understadd that I must sobedifle,and pass all required Inspections for the perinit to be furled. Further, I
understand that this is a ONE MZZKS_MWAIL MO Ike permit shall expire should I not receive a
passing-inspect%on d many sig'uioz�th period d � tie renewal period.
JustlfiCafienY C�.�� ? .
4WNERMLDR O. CONTRACTOR SIGNATURE DATE
K w
Pxi,ut Namey
• •- ••--• - ,!►g�A 17,2#22 s:1as.•
STATE OF FLORID(
COUNTY OF
ACKNOWLEDGED$EFORE,ME THIS T DAY OF ,20
BYWHO ME .OR
l�j
HAS PROVIDE..D � �y AS IDENIMCAUON.
STATE OF FLORWA,Co of �/}• 1► I lA ....----- ----
SI OF NOT SEAL
FOR OFFICE USE ONLY;
i\umber of Open Inspecdo;is'•-_-••
Total Inspections• r
(Divide open by total to get%of r y�inspections)
Ferceutage: ----- ..•
origiinal permit fzm x%open ='$_Renewal fee
Example, (15 divided by y3=.65(%3� 5175(pe[noit fee)x.55=$113.75(renewal fee)
•Revised 7/21/2014