HomeMy WebLinkAboutPermit Renewals Mar 06 2020 11 : 43AM UPS .STORE HOBE SOUND FL 772 545 2208 p. 1
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
RECEIVED
PERMIT RENEWAL REQUEST
MAR 0 6 2020
ST. Lucie County, Permitting
PERMIT NUMBER: Lq(-? p r U �.�i ADDRESS:_ f D7_UD S O cea.n 'Ol~
am requesting that the above permit be renewed. I
unarst�d that I must schedule and pass all required inspection's for the pen-nit 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 ou-y C}- ±Laj 1 I�YJ►�Y1�" Yf ttl��ltaC1
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�OWI� LDR OR CONTRACTOR SIGNATURE DATE
Print NNaLne
STATE OF FIL01f
COUNTY OF `r
ACKNOWLEDGED BEFORE ME THIS DAY OF V ,20
BYE �" 2� = IC�A r E
}�QO� WHQ IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDEDY1 AS IDENTIFICATION.
S TE OF FLORIDA,Co ty of
'Ip�II �I/f +i 39e-ois3 PAMFLA J HAOLy
Notary SIGNATURE OF NOTAR son F54
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total cc 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