HomeMy WebLinkAboutPermit Renewals 01/16/2020 THU 2: 34 FAX f�001/002
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
EINE® FORT
VIRGINIA AVE
RT PIERCE,FL 34982 ^
(772)462-1,W Pax(772)462-1578 ►�]
JAN 17 2020
ST.Lucie County,
Permitting PERMIT RENEWAL REQUEST
PERMIT NIJMBER: 0�•v ADDRESS: Il i S 06Z" LZ5
1, ,aln requesting that the above permit be renewed. I
un erstand that I must sche le and pass a 1 required inspections for the permit to be ftnaled, further, I
understand that this is a ONE TIM,_E RENEWAL and the permit shall expire should I not receive a
passing inspection ring any six mont pert d during t e renewal period.
Justification
I
OWNEIUBLDR QM CONTRAtZR SI TURE DATF~
rc ��
P nt Name
sTATR OF FLORIDA (�,
COUNTY OF �..A�" #^ �yex
ACKNOWT.ET)GED BEFORE ME THIS DAY OF��t-�.� L,-<—.20
���
I3Y���� WHO IS PERSONALLY KNOWN TO MF� ,OR
HAS PROVIDED AS IDENTIFICATION,
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ST.A7T:0F PLO1iIUA,County of �r,P�� ,byCE LW}{g7=942"]MYCOlANISt310N x(3
S�ai
OF ~ Y
SEAL E)IP1R� .*1X
BMdeO]lru No two
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections;
(Divide open by total to bot%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)
Ravioad 7/21/2014