HomeMy WebLinkAboutPermit Renewals s(
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
r X ' BUILDING AND CODE REGULATIONS DIVISION
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2300 V=1RG1\irk AVE ----EM
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FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
Y 2 0 20210
PERMIT REN'E'WAL REQUECo..", Permitting
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1704-0564 25 Lake Vista Trail 204
I PERMIT NUMBER:_...___ -...-_._ _ __:___ ADDRESS v - _ ---_-- _--
f i Scott Camiretam requesting that the above permit be renewed. I
utiderstaitd that I must sched Ce and;pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONETIME RENEWAL and the pen-nit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
0.
�. s 5-20-2020
I Iy tiORCONTRAC"iOR-SIGNATURE
Scott Caniire�J_ _
� Punt Name —_
i .
STATE OF FLORIDA -
l COUNTY OF St Wce -
ACKNOWLEDGED BEFORE ME THIS 20 DAY OF Mayp
_ _ t 2 20
BY Scott Camire WHO IS PERSONALLY KNOWN TO ME XXX OR
HAS PROVIDED AS IDENTIFICATION,,
i r St Lucie Jamie Perna
,STATE OF FLORT,D�`A„ data of ,'' �'
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_. .: •,NQTARY PUBLIC
SATE OF FLORIDA
SEAL CotrxrtkGM7323
Expires 1012812022
i•
t FOR OFFICE USE ONLY: A4
Number of Open inspections:
Total Inspections: _-
(Divide open by total to get%of open inspections)
l_._. �%rC6A _ --
iOr# tiff permit fee:.-..._. ____,x%open = $r Renewal fee
Example: j 1 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 71`21!2014
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