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HomeMy WebLinkAboutPERMIT RENEWAL_DempseyBUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772) 462-1553 Fax (772) 462-1578 PERMIT NUMBER: 1908-0317 ADDRESS: 5211 Palmetto Dr 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 The inspections were not completed and we need this permit active so a final inspection can be scheduled and completed. OWNERBLDR OR CONTRACTOR SJ&ATURE Roberto Sanchez Print Name STATE OF FLORIDA �9 COUNTY DATE ACKNOWLEDGED BEFORE ME THIS 6'°-- DAY OF , 20 BY Roberto Sanchez HAS PROVIDED WHO IS PERSONALLY KNOWN TO ME.X , OR AS IDENTIFICATION. STATE OF FLORIDA, County of 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 &til'on Hallich ARY PUBLIC 9 ; i >)JE OF FLORIDA GG951577 ) 1/27/2024 ACKNOWLEDGED BEFORE ME THIS 6'°-- DAY OF , 20 BY Roberto Sanchez HAS PROVIDED WHO IS PERSONALLY KNOWN TO ME.X , OR AS IDENTIFICATION. STATE OF FLORIDA, County of 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