Loading...
HomeMy WebLinkAboutPermit Renewals _ PLANNING AND DEVELOPMENT SERVICES DEPARTMENT . ,I BUILDING AND CODE REGULATIONS DIVISION . 2300 VIRGINIA AVE -_ FORT PIERCE,FL 34982 . 7V5d (772)462-1553 Fax(772)462-1578 FEB 2 5 2020 PERMIT RENEWAL REQUEST, wel®c®-urrty, POrmIttlflT9 PERMIT NUMBER: I -I©(Q- 0 r2_00ADDRESS: - � 7 2u-;- 1:2 I, Ko_Szd5 ,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 Tpnth peTiod during the renewal period. Justification /7 ©Zo 0 LDRR NTRACTO N T DATt Print Name STATE OF FLOP-IV� COUNTY OF ACKNOWLEDGED BEF/Q3E ME THIS oLAS DAY OF 20c;�u BY(�fi ' WHO IS PERSONALLY KNOWN TO ME ,OR HAS PROVIDED AS IDENTIFICATION. STATE OF LORIDA(Tnty o 4, Luc,it SIGNATURE OF TAR `�1pPY PVA KAREN S. N I E ls�,tssN ��;State of Florida-Notary Pubiic =' Commission # GG 207484 My Commission Expires OF F� FOR OFFICE USE ONLY: Number of Open Inspections: Total Inspections: (Divide open by total to get%of open inspections) Percentage: 6' 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