HomeMy WebLinkAboutHumphries.Generator Permit Renewal. 1 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34482
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1911-0449 ADDRESS: 15355 Skyking Drive
I ,Joseph E. Herndon, Sr. ,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 - F-6 rn e o w n e, a lc u te.¢ A n d
08/24/2020
OW7XmI)k OR CONTRACTOR SIGNATURE DATE
Joseph E. Herndon, Sr.
Print Name
STATE Of FLORIDA
COUNTY OF St Lueie
ACKNOWLEDGED BEFORE ME THIS 24th DAY OF August 2020
BY Joseph E. Herndon, Sr. WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County or St Lucie
e _4r Notary Public State of FfariiR
Randolph MCDin*
My Cammisswn CG 352355
SIGNATURE OF NOTARY SEAL a Excites 09107=3
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: [15 divided by 23=.65(%)] $175(permit fee)x.65=$113.75 (renewal fee)
Revised 7/21/2014