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HomeMy WebLinkAboutPermit Renewals _ PLANNING AND DEVELOPMENT SERVICES DEPARTMENT r BUILDING AND CODE REGULATIONS DIVISION s 2300 VIRGINIA AVE __ FORT PIERCE,FL 34982 — �F_CPIUED RECEIVE (772)462-1553 Fax(772)462-1578 L:� 172019 DEC 17 2019 PERMIT RENEWAL REQUEST. ST. Lucie County, Permitting • Lucie Coun tY, Permitting PERMIT NUMBER: ©0 V ADDRESS: 37 ,DeQ-P t&hl'rc 21-11 d. I,}- e �� , am requesting that the above permit be renewed. I unde-rstand 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 / l.7I O R OR CONTRACTOR SIGNATURE D TE tear. Nle llev Print ame STATE OF FLO D COUNTY OF ff ACKNOWLEDGED BEFORE ME THIS DAY OF 20 BY _F �j fl,o WHO IS PERSONALLY KNOWN TO ME OR HAS PROVIDED ���I_ AS IDENTIFICATION. I STATE 0 FLO A,Cork y I �� jk SI NATURED NOT Y Z.I ��,, KAREN S. NIELSEN S ;a �sState of Florida Notary Public o Commission # GG 207484 .11IFF`o`, My Commission Expires - June 121 2022��_ 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 = $ 7� Renewal fee Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75 (renewal fee) Revised 7/21/2014