HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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® BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE L(',[���
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 0 3 2020
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PERMIT RENEWAL REQUESTty, Permitting
PERMIT NUMBER: 130 ] oZa ADDRESS:
I Peter A Cafaro I II , 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 per, a Q.S 44-, pi, t wt9Lr
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OWNER/BL R OR CONTRAC OR SIG AT RE DAIE
Peter A C aro III
Print Name
STATE OF L RIDA
COUNTY O ORANGE
ACKNOWLEDGED BEFORE ME THIS_�Z DAY OF aLr-c� 20 r j
BY PETER A CAFARO III WHO IS PERSONALLY KNOWN TO ME X 'OR
HAS PROVIDED AS IDENTIFICATION.
T I A,C only of O ANGE =o .
°��`of FloridaS GNA RE OF N ARY SEAmmissionFF9S1sa7
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