HomeMy WebLinkAboutPermit RenewalPLANNING 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: 1911-0007 ADDRESS: 3163 Hammond Rd.
I James Brann , 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 To obtain final inspection.
OR CONTRACTOR SIGNATURE
James R Brann
Print Name
STATE OF FLORIDA
COUNTY OF 8t. LUC1e
ACKNOWLEDGED BEFORE ME THIS
BY James R. Brann
HAS PROVIDED
STT OF FLORIDA, County of St. Lucie
. . --7
TURF OF NOTARY
FOR OFFICE USE ONLY:
5 -I g -'20go
DATE
DAY OF / " '20010
WI -10 IS PERSONALLY KNOWN TO ME X OR
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
AS IDENTIFICATION.
KRISTINE MICHELLE TAYLOR
0
,"State of Florida -Notary Public
SEAL r ` Commission # GG 1 p5618
M Commission Ex gyres
n m" October
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014