HomeMy WebLinkAboutMisc Letters PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1-70- (o— 065 ADDRESS:
Dennis Zacek _ ,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 Permit Expired
OWNER/BLDR O NTRACTOR SIGNATURE dATE
_ Dennis Zacek
STATE OF OF FLORIDA
COUNTY OF St Lucia.County
ACKNOWLEDGED BEFORE ME THIS DAY OF_/y�l/�� ,20so
BY 1 Uy)eLkWH0 IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED .. _ Drivers License AS IDENTIFICATION.
ST E OF FLORIDA,County or 5\ LUC te- C our ACV MELISSA CHATEAUNEUF
State of Florida-Notary Public
Commission#GG 340178
SIGR14MURE OF NOTARY SEAL My Commission Expires May 30,2023
"AallIPIG. tlJ UIV IU6U Uy LJ--UJk ro)] at rJ1lJC1 Ilul MC]A.UJ-.Dl lJ. J ki C.M.Wal lcc)
Revised 7121£2014