HomeMy WebLinkAboutPermit Renewal'1PLANNING AND DEVELOPMENT SERVICES'DEPARTNEENT
33UELDING AND CODE REGULATIONS DIVISION
2300 V IRGMAAVE
FORT PIERCE, EL349M
CM)462-LW FaxM2)462-r '�r-
PERNUNIT
Justification
PERI%ffr RENEWAL RE uES-JU N 19
ST. LUcle county, Perr
ER 10509- -ADDRESS. 988o S, -0 &40
Nr- am requesting that the above permit be renewed. 1
1 must schedule and pass all,required inspections for the permit to be finaled. Further,l
this is a ONE ITHE •RENEWAL and the permit shall expire should I not receive a
on d)" any six month period dtTft.er!newal p niodd
-dWNER/BLDR DR GONTRACIOR SIGNATURE
Print Name if:
71
STATE OF FUMID4M
DATE
Cowasim#GG206194
COUNTY OF - ADOWLEDGFDBEFORE.METkUs ILP"'
�.AYOF IC-Itlelk— —12Q-55aQ-
BY Kim lal is(p —VPAOISJpERSONALLY KNO TOME OR
HAS PROVIDED AS IDENTIF[CATION,
FOR OFFICE USE ONLY:
-umber of Open Inspections:
Total luspec�tions:
(Divide open by total to get % of -open inspections)
Percentage: -0' .. ..' %
Original permit f=:. 7 x%opea- Rzacwal fee
Example: [15divided by�
-1
Revised 7121/2014
9