HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
DEC 18 2019
PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
PERMIT NUMBER: / >�'- ADDRESS: l °76 J
I, � am requesting that the above permit be renewed. I
understand that I must schedule and ass 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.
JustificationLnk-m-rte CA(_(_ too, Zt,s,!.�-41 O',4
R/BLDR CONTRACTOR SI TURE DATE
Print Name
STATE OF FLORIDA
COUNTY OF_ tcA 1(,L
ACKNOWLEDGED BEFORE ME THIS I(o-t DAY OF�,M b=E( 20 /,?
BY 6)e yLL `� 'D • V.)Q,, WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED I • �L • AS IDENTIFICATION.
STA DA,County of/
E .0 xta� Notary Public State of Florida
l Carmen Espinoza
GNATURE OF N Y S) pMy Commission GG 2663913
?OF V Expires 1 011 412 02 2
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