HomeMy WebLinkAboutPermit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578 RECEIVED
PERMT RENEWAL REQUEST AU G 0 3 2018
ST. Lucie County, Permitting
PERMIT NUMBER: SIC- I / i g,"" '• ADDRESS: /Q/ L 1 aP 09/1
I, X e n o F F" am requesting that the above permit be renewed. I
unde stand that I must sch dule 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. d
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• :l/• • • • 64�k DATE
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STATE OF FLO
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 3 - DAY OF 20—IL
BY /may R)N V ZUi`lFE WHO IS PERSONALLY KNOWN TOME OR
HAS PROVIDED
STATE
AS IDENTIFICATION.
of Flonca•���•-•
..,.facion # GG 207484
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 = $ 5.r Renewal fee
My
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7212014