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
FEB 21 2020
PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
PERMIT NUMBER: [ v 6 —0 OSADDRESS: S v iqk and � ah C t Y
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 �n L d (,�/Gi Qyc 2 lei f/-
Cz-S S
OWNE OR CONT OR SIGNATURE DATE
�l SS l Y7 Y
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS a. DAY OF e 20�
BYy�\S q g Ly ,^c` WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED L L- AS IDENTIFICATION.
STATE OF FLORIDA,County of
DEANNA MARIE GIVENS
SIGNATURE OF NOTM My C0Mt4WN#GG 022023
as EXPIRES:December i6,2020
Bonded Thru Notary Public Underwriters
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