HomeMy WebLinkAbout1407-0439 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVI RECEIVED
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578 APR 2 0 2020
PERMIT RENEWAL REQUEST ST. Lucie County,I Permitting
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PERMIT NUMBER: ADDRESS: G 305 A4 9 Dr,
Fa-u-sm laat--.am requesting that the above permit be renewed. I
understand that I must schedule at ass 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 renewa[period.
Justification vie-;h49 LAJ
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0 WNI--'RJIfLD--R0�[�CO TRACTOR NATURE DATE
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Print Name -E U0
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S1'ATE OV
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('OLJNTY' OF 0 P CA-
ACKNOWLEDGED BEFORE METHIS DAYOF
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>1 BY WHO IS PERSONALLY KNOWN TO NIE OR
I IAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA.County of
SIGNATIME01'No TARP SEAL
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total inspections:
(Divide open br total to get%ofopen inspections)
Percentagc:
CL Original permit t'ce: X%open Renewal fee
Example: [t5 divided by 23=.65(%)j S I 75(permit flee)x.t+5=5113.75(.renewal fee)
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