HomeMy WebLinkAboutPermit renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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DIVISION BUILDING AND CODE REGULATIONS
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(772)462-1553 Fax(772)462-1578 1 1 t
Permitting Department
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PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1903-0561 ADDRESS: 1114 Nettles Blvd Jensen Beach, FL
Steven Drake Marston Jr 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 I did not realize I needed a ladder set up. I will have it set up and secured off
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OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
Steven Drake Marston Jr
Print Name
STATE OF FLORIDA
COUNTYOF nj.j-k).e; C- I
ACKNOWLEDGED BEFORE ME THIS'
DAY OF n 20A
B "ViIC)IS PERSONALLY KNOWN TOME OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of a, LUL,CC
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SIGNATURE OF NOTARY SEAL11 L-k--ftWTN=�EXPIRES: MZ 22,2022
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to Iget%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