HomeMy WebLinkAboutPermit RenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 1510-0439
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 2715 S. 29TH ST. FT. PIERCE ,FL 34981
I, CHRIS JOHNSON , 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 THERE WAS A MISCOMMUNICATION WITH THE CUSTOMER AND THE OFFICE AND THE PERMIT WAS MISSED.
O RBI R OR CONTRACTOR SIGNATURE
CHRIS JOHNSON
Print Name
4/27/20
DATE
STATE OF FLORIDA
COUNTY OF ,S%— LP, --/f
ACKNOWLEDGED BEFORE ME THIS a �% DAY OF %4"/Z/ �, , 20 20
BY
HAS PROVIDED
WHO IS PERSONALLY KNOWN , OR
AS IDENTIFICATION.
STATE OF FLORIDA County of S % , 1 lel C I f�
`?Q,•eL� Notary PublicH
State of Florida
Commission N GG 311213
SIGNATUkt OF NOTARY / SEAL '•'� of ��° ' My Comm. Expires Mar 22, 2023
Bonded through National Notary Assn.
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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