HomeMy WebLinkAbout1407-0223Jun 10 20, 09:32a Treasure Coast Roofing 7723438358 p.3
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
1 0 = BUILDING AND CODE REGULATIONS DIVISION
23B0 VIRGINIA AVE
FORT PIERCE, FL 34982 _
(772) 462-1553 Faa (772) 462-1573
PERMIT NUMBER: 446 7— 0 3L. 3
understand that 1 must schedu
understand that this is a ONE
passing inspection during any
Justification ) —
OW NER/BLD OR CQ?QTR67rOR SIGNATURE
Print Name
PERMIT RENEWAL REQUEST
ADDRESO -6it F1 W '%5 � St•
am requesting that the above permit be renewed. I
required inspections for the permit to be finaled. Further, I
WAL and the permit shall expire should I not receive a
od during the renewal period.
DATE
STATE OF FLORIDA . ;
COUNTY OF '
ACKNOWLEDGED BEFORE ME THIS ..,�DAY OF _ L.7hl. . 20o-2<2
BY /S/%Ayi /"fLL�l?P.� WHDISPERSONALLYKNOWNTOME IL OR
HAS PROVIDED AS IDENITIFICATION.
STATE OFFLORIDA, County of S7 1.1 is o,
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.r41°Nr Notary Public State a7 Florida
SIGNATURE OF NOTARY SEAL. +° `f` Victor G Alterizio
�• a My Commasim GG 274292
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get °A of open inspections)
Percentage:
Original permit fee: x %open = S Renewal fee `
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=5113.75 (renewal fee)
Revised 72112014
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