HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
.BUILDING AND.com REGuLATIoNS DIVTSI4N
2300 VIRG01A AVE
FOR MRCE,FL 3492
('772)467-1553 Fax(773)462- 578
pE 'r RFNTwAL REQUEST
pE _ a - 0 D�Ess Sao Owl)
1,
�` (,er6 e( 1 j►A Q.ltd am rquestang that the above pertuit be renewed. I
understand thAt I must sche4lp-aud pass all required mspeckion.for the permit,to be finaXed. Further.
uiiderstaltd that this is a. NE and the pernvt'shall empire should I not receive a
mouth 'odd renewal riod.
passzug'insectaon d any six mon peri 1 ,
Justification � �
IJ -7 Illiq
W ER/BLDR OR CONTRACTOR SIGMATURE DATE
f l hAl
E alt Name !� ►
APM
#Q62�8184
M. InLL•"'7 fIo.�ONrw�N9.��
STATE OF FLOI LDA
COUNTY OF N
ACKNOWLF-DOER BEFORE,M.F TWS�� DAX OF
BY ay--Ip.�(t� wk€Q PBI�SONALLY YO`id 1�O 1�FF; ,OR
HAS PROVIDED AS IDENTMCAUON.
STATE OF FLORIDA,Countybf
451a*—OF NOT '
• SEAL
FOR OFFICE USE ONLY.
Nurn.ber of Open lnspeetions-
Total Insp=tions:
(Divide open by total to get%o£open inspections)
],percentage- ;
Original poxxnit fee`. . x%op= $ R WE%mi fee
Lxampjc. [15 divided by 23=_65(%)] fee)x.65=$113.75(renewal free)
,(tevisxd 7/21fzOx4 Rgm
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JUL 11 2019
Permitting Department
St. Lucie County, FL