HomeMy WebLinkAboutPermit Renewals Nov.21.2019 15:37 B & D Grading and Land C1 7728705271 PAGE. 1/ 2
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
•_ 2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVE
(772)4621553 Fax(772)462-1578
NOV 2 2 ?049
PERMIT RENEWAL REQUES
ST. Lucie County, Permitting
PERMIT NUMBER: D�'~ Ip ADDRESS: `
am requesting that the above permit be renewed. I
understand t—hafl must schedule and pass all required inspections for the permit to be fnaled. 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
�r liev um 1- 19
O ER/BL OR CON'T'RACTOR SIGNATURE DATb,
/int me
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS ?I DAY OF 20
BY �Q� _WHO IS PERSONAL �NOML OR
HAS PROVIDED AS IDENTIFICATION,
STATE OF F ORIDA,County of
'IC
F OF NOTAR SEA {F::YDt �;; AUDREY B.NUMPyRFY
MY COMMISSION 16 GG 300047
w9 ,ia EXPIRES:March 6.2023
:Y2`�'' fi6ndN
edlbruNota PoNicOndenwiters
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 V21/2014