HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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m4�' BUILDING AND CODE REGULATIONS DIVISION
'2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUE T RECEIVE®
FEB 1 .1 2020
a ST. Lucie County, Permitting
PERNUT NUMBER: 9 d�6"U[ I(p ADDRESS: L CM� Dr-a aci C- �ve-j
I, 3 m ne--, W ft Uef ,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 \Aa,V)y-\ �� �In 1
O \ R/BLD OR CONTRACTOR SIGNATURE EJA7VE
J my)e5 A'\ OLA-,c,6
Print Name
STATE OF FLORIDA
COUNTY OF -,h. Low*,--
ACKNOWLEDGED
,cACKNOWLEDGED BEFORE ME THIS DAY OF
BYSa w�R S S WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED C L L- AS IDENTIFICATION.
STAT�=RE
OF FLORIDA,Coun of '�-�-Oe< e e
�a
,ole.;y9 :- DEANNI MARIE GG NS
22
MY COM4dISSl4h#GG 022023
SIGNATNO Y = S F PIRES:December 16,2020
Bon`d'a Thru Notary Public Underwriters 1
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