HomeMy WebLinkAboutPermit Renewals 06/05/2020 03:14PM 7723367272 The Plumbing Works PAGE 01/01
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
pn , BUILDING,AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE RECEIVEta
FORT PIERCE,.FL 34982
(772)4621553 Fax(772)462-1578
JUN 0 9 2020
PERMIT RENEWAL REQUEST ST. Lucie County, Permitting
PERMIT NUMBER: i �I � : ADDRESS,
1, �Q1 U -SA{, 6A ,am requesting that the above permit be>renewed. I
understand that I nfust sche ule artd pass all required inspections for the permit to be finaied. Further,I
understand that this is i 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
0 LDR OR ON IGNAT'URE DATE
Print Name
STATE OF FLORIDA
COUNTY'OF_fit} l ei c_iL
ACKNOWLEDGED BEFORE ME Tk1IS DAY OF .20 20
BY I>XVi J [u+i s2q WHO 15 PERSONALLY KNOWN TOME X OR
HAS PROVIDED _ AS IDENTIFICATION.
STATE OF
FLORIDA,County of _5 d.Lu..c." t'yr'i , tiREt+D�St
OECARA
' � Notary PubNate of Flartda
A �'. tammiSsiGG 310775
SIGNATURE OF NOTARY SEAL D ov �f Ay Comm.Expires Jul t,2023
Bonded through National Notary Awt.
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.654113,75(renewal fee)
Revised 7/21/2014