HomeMy WebLinkAboutPermit RenewalFrom: Mike Heissenberg Fu:17728710990 To: Fax: (772) 462-1576 Page; 3 of 4 06/2912020 11:34 AM
..PLANNING AND' DEVELOPMENT SERVICES DEPA. YRTME T
• BUILDING CODE REGULATIONS DIVISION.
CE
IR, L34982
2300 RGINIA. AVE _.
FORT PIERCE,
- . (?72).40271553 ....F.a4 (77.2)462-1578 RECJ
CEIVED-. ...
PERMIT RENEWAL REQURST
... _..... 57 ntY,.Perhlittirig._
PB$MI(T�jN�U�jMpSER ADDRESS: (I LI U ( Won o1 1 t✓f 47I i f
am :requesting that the above pzrmiC be renewed. I
understand that Lmust sehedule.and p s all required inspections for the permit to be finaled. Further,.]
understand that this is a ONE TIME RENEWAL and the permit shall expire should I. not receive. a
passing inspection during an`y/�six'(moDnt1h �erilod during the renewal period, ` Justification Y%r_i�i'� � l f Y-l_1hJ� I�T t C
OWNERIaLDR613CONTAACI'OR.SIGtS/A ZQ
PATE
STATE OF FLORIDA('
COUNTY OF '
OR
ACKNOWLEDGED BEFORE ME THIS Z l!t 1 (t
DAY c ��..
BY �L1�, 1"5� ���� bP.YGI do IS PERSONALLY KNOWN TO &1E : OR .:.
.HAS PROVIDED .
_.. . AS.IDENTIFICATIQN.
:.STATE OF FLORIDA, County sf i , ..
SIGNATURE O..F.NOTARY..� Tnytor O'Brien
NOTAiY UBLIC
^STATE OF FLORIDA
J ? Comrtr✓I W958999 ..............
FOR OFFICE USE ONLY; - —
xP{reS7/Eff24
..._ ..........................
Number ofOpen lns
Total Inspections: _........_...._...._ _ ...
(Divide open by total to getof open )ns ections -- P ) .
Percentage: .. ....................... _......................... .........................
Original permit f— ea X °a open = S.R6ncwal fee.
.:..........................................................
Example; I15.divided by.23=.65(%)] S.I'75(permit fee) x .65=S 1 I3.75 (renewal fee)
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