HomeMy WebLinkAboutPermit RenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, Fl, 34982
(772) 462-1553 Pax (772) 4624$78
PERMIT RENEWAL
MAY 2 0 _020
ST. Lucie County, Permitting
PERMIT NUMBER: _ 1 1 I I — O' q ,0-1 ADDRESS: —t I i 110w S AV e.
I. DenniJ (a es •f q , 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. Furth r.
understand that this is a ONE TIME, RENEWAL and the permit shall expire should 1 not receive a
passing inspection during any six moot period daring the renewal period.
Justification
OWNER/BLDR OR CONTRACTOR SIGNATURE lJA I C
nn,s C'u e�
Print Name
SPATE OF FLO DA
COt1NTY OF _ __yn_yt(, p , /
ACKNO ,.EDGED BEFORE ME THIS _1.,7 DAY OF. Max 20 p.
BY L,(P��a WHO IS PERSONALLY KNOWN TO ME1.
V OR
HAS PROVIDED
ST F FLORIDA. County of _ _. /_ /� U L-1Z
SlIGNATURE OF NOTARY
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 = S Renewal fee
AS IDENTIFICATION.
Notnry Publb Sleti otFlaleer..•.
q
SEAL B
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Example: (15 divided by 23-.65(°/u)) S175(permit fcc) x .65=$113.75 (renewal fee)
hevised W21/20I4