HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
o _ 2300 VIRGINIA AVE C
FORT PIERCE,FL 34982 ���' � �
(772)462-1553 Fax(772)462-1578
MAR 0 3 2020
PERMIT RENEWAL REQUEST • Lucie Gounty, Permitting
PERMIT NUMBER: ' )�— O�`7� ADDRESS: D O�� �`�l� 0,wc,��cc
I Peter A Cafaro III 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 2. Z 2 0 G-t
OWNER/BL R OR CONTRACTOR SI N TURE DAT
Peter A faro III
Print Nam
STATE OF ORIDA
COUNTY OF ORANGE
ACKNOWLEDGED BEFORE ME THIS DAY OF -'20
BY PETER A CAFARO III WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
T E LORIDA County of OR GE
arty Notary Public State of Florida
�° Kari M Riccaboni
SI NA O NOTA Y �� My Commission FF 981647
' OF IV My
Expires 05/2812020
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(pennit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014