HomeMy WebLinkAboutPermit Renewals YLAAIINJUIN"Alrll 11L' V L'LVr1V1L'lr 1 M n V 11,L'a 1/L' rAl(11VM1N 1
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BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
- FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 7REC:EIV:EDPERMIT RENEWAL REQUE TST. Luing
PERMIT NUMBER: 1905-0685 ADDRESS: 3701 AVENUE O
I, ANDREW A OMOTOSO 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 know that my agent had not requested for an inspection.
I received notice of expiration of permit dated January 30 2020 in the mail yesterday
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OWNERBLDR OR CONTRACTOR SIGNATURE 15ATE
A N ,�kC—d A 6 VULO[ CO
Print Name
STATE OF PE-ORM
COUNTY OF a I S�-e V, r^
ACKNOWLEDGED BEFORE ME THIS DAY OF FC,V ru ,200
BY �� � �I�l,l U WHO I3 PERSONALLY KNOWN TO ME P`*'�,OR
HAS PROVIDED AS IDENTIFICATION.
IVEw o►-k � C S��r
STA County of DIANE M. STONES
7
Notary Public in the State of New YorF .
Y ATURE OF NOT SEALResident in and for Ulster County
Commission Expires August 24, 20
# 4902670. e
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(0/o)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014