HomeMy WebLinkAboutPermit RenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1811-0285 ADDRESS: 1651 NW Swat Bay Cir. Palm City FI 34990
Jeffery J Pauly , am requesting that the above permit be renewed. I
understand that I must schedule 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.
Justification I was waiting for the onwer to finsh her landscaping before I had final
pre -treat done, now that&ie pre -treat is done and sumitted I can do final inspection
(o ! / o I g0g-o
DATE
Jeffery J Pauly
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY 017 I//1/7ct�- , 20,90...
BY} B 1'Hry J • I UU j y WHOJS'PERSONALLY KNOWN TO ME OR
HAS PROVIDED rL J?G EXO. /������ AS IDENTIFICATION.
STATE OF FLORIDA, County of z2&=.—ii/
�.ay /7 ual�ps�� DIANE KIRKLAND
SIGNATURE OF NOTARY NotsyAeublic
State of Florida
Comm# HH002375
-4-rA> IV[ EX01res 5/25/2024
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: 115 divided by 23=.65(%)] $ l75(permit fee) x .65=SI 13.75 (renewal fee)
Revised 7/212014
sty �aa-da�a- oaa 1 P add