HomeMy WebLinkAbout10921597_RENEWAL_GuntherPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
x BUILDING AND CODE REGULATIONS DIVISION
6MENEM-,
2300 N7IRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1908-0600 ADDRESS: 162 U Vista Court, Ft Pierce, FL 34947
I, ROBERTO SANCHEZ , 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 Please extend the above referenced permit. We ran into issues with ordering the products that prevented us from
complementing the project before it expired
s
OWNER/BLDR OR CONTRACTOR SIGNATURE
lobccvo 3C&r)Cyy-2-
Print Name
STATE OF FLO-FIDA
COUNTY OF Lu L,
Z -
DATE
ACKNOWLEDGED BEFORE ME THIS DAY OF M a.y,c,h , 20 0
BY ( h ar- p Ca,,A WHO IS PERSONALLY KNOWN TO ME _ O , OR
HAS PROVIDED
AS IDENTIFICATION.
STATE OF FLO DA County of �(- Lu G1
SIGNATURE OF NOTARY SEAL
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
Ashley beings
NOTARY PtJULIC
s -111
, STAT E- OF FL R10A
' ', Comm C�C23 ,5648
°"y 512122