HomeMy WebLinkAboutPermit Renewals _ PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
r W � - _ ' ' BUILDING AND CODE REGULATIONS DIVISION
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2300 VIRGINIA AVE
-- — --- FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
RECEIVED
PERMIT RENEWAL REQUEST 7020
AUG 19 -
permitting Department
(y St.Lucie County
PERMIT NUMBER:;� ADDRESS: O 6' r
I, � FCC e, �'� ,am requesting that the above permit be renewed. I
understand that—I u 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 t
month period during the renewal period.
Justification
O ERBLD OR C09AACTOR SIGNATURE DOE
Print Name
STATE OF FLO A
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF 20 �
�J I C' I �
BY 'rn'(�C f ) WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED R� AS IDENTIFICATION.
ST TE OF FLORIDA,County of
C_\
SIGNATURE OF NOTARY KAREN S. NI EN
'e° --State of Florida-Notary Public
`c Commission # GG 207484
FOR OFFICE USE ONLY:
June 12, 2022
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fee
Example: (15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014