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 REQUES N O V 18 ')-0',9
ST. Lucie County, PerMIWng
PERMI ER: 5 11 ADDRESS: � �sa�✓�
I,z��5 --ate ' ,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.
Justifications���t,�,�
20!5VINE r OR CONTRACTO SIGG'NATURE ATE
Print Name
STATE OF FLORIDA
COUNTY OF � '24.�� f- ,v ,
ACKNOWLEDGED BEFORE ME THIS DAY OF O 20 19
BY 1 q milky G6-k' WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of S fit'. �--O c•�'f .ot."�`.�''•, DEANNA7MAR7.
* MY COMMISma: EXPIRES:�tBondedSIGNATURE OF NOT Y
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