HomeMy WebLinkAboutPermit Renewal Request To: St Lucie County Affidavit Building Affidavi Page 1 of 2 2019-10-10 16:19:31 (GMT) 17729070420 From: Rod Waller
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
e.x . 2300 VIRGINIA AVE
FOR'r PIERCE,FL 34952
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
'I
YERNMITNUMBER: 1502- 0200 ADDRESS: 151 SE Serenata DR, Port St Lucie
1 Gerard Thelusca _ am requesting that the above permit be renewed. I
understandthat t must schedule and pass all required inspections for the permit to be finaled. Further,T
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 To perform a Final Inspection
- y 10/10/2019 --- — ---
01i4'NERBLDR OR CONTRACTOR SIGNATURE DATE
Gerard Thelusca
Print Name
STATE.OF FLORIDA
COL,N'fY OF ST.Lucia
ACKNOW'I.I:DGED BEFOREME.TIdIS 10th DAY OF October 20 1.9
BY Gerard Thelusca WHO IS PERSONALLY KNOWN TO ME XX OR
HAS PROVIDED AS IDENTIFICATION.
STA 7 FLORIDOCounty of T I)tle
Publ�Std o$�lot►da
Sophia Harris
IGNATURI F.NOTARY S my Comm]=�GG 238873
Expiras OUM02u
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit tee: _ x%ripen == $ Renewal fee
:Example: [15 divided by 23=.65(1/b)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7121;201 i
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