HomeMy WebLinkAboutPermit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIINIIA AVE
FORT PIERCE, FL 34982
(772) 4624553 Fax (772) 4624578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1912-w0542 ADDRESS* 5415 Davis St.
IManuel Joseph Duran , 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 ONfNW RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification Out Of State
.M.
on
"LDR OR..,CONTRACIVOR SIGNATURE
Manuel Jte6P h Duran
Print Name
09n0202020
DATE
STATE OF FLORIDA '
COUNTY OF � �- • ��l C. � -�._
ACKNOWLEDGED BEFORE ME THIS 2 DAY OF September 2020
BY Manuel Joseph Duran W110 IS PERSONALLY KNOWN TO ME X , OR
Wq
HAS PROVIDED AS IDENTIFICATION.
ST T E OF FLORIDA, County of
4
SIGNATURE OF NOTARY
AL
41
SEAL
1 4W
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
Ariana Ven iano
NOTARY PUBLIC
STATE OF FLORIDA
� Comm# GG 185914
Expires 2/14/2022
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGEWA AVE
FORT PIERCE, FL 34982
(772) 4624553 Fax (772) 4624578
PERMIT RENEWAL REQUEST
PERMIT NUMB
ERa 2002-v=0085 ADDREss: 610 Ramie Ln
I, Manuel Joseph Duran , am requesting that the above permIll
it be renewed. I
understand that I must schedule and pass all required inspections for the perrnmut 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.
JustificatIM
ion Med'ica
a �
onditions
OW-NER/BLIAR OR AONTR.1ACTOR *GNATURE
Manuel JoseplrDuran
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS 2
BY Manuel Joseph Duran
09RO202020
DATE
,2020
WHO IS PERSONALLY KNOWN TO ME X , OR
nAV n1R
Septmeber
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA, County of
�y
uk.�
SIGNATURE OF NO
y
-A
LX
y
q.doll NEd
SEAL
Tic e 19��
mp Fm ON riY� ikEdM"MYT=&MWft ridmY Y YiEii Y illllW iFiL i#1*7w�11 ��
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(perrmt fee) x .65=$113.75 (renewal fee)
Revised 7/2112014
Ad'ana Venezi*ano
NOTARY PUBLIC
STATE OF FLORIDA
Comm# GG 185914
Expires 2/14/2022
�4i1 � j�iliLllf � � ��i � i■ Yik� yii iit�# iiil ■■I iiiY�Y WL � � �� t� 1i1 W iY# �#iiif �1li�k
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIMA AVE
FORT PIERCE, FL 34982
(772) 462-4553 Fax (772) 4624578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2001-0226 ADDRESs: 427 Nettles Blvd
IManuel Joseph Duran , 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
undeIIIrstand 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
Justification Medical`
OVVNERIBL
R �ONTRACT R SIGNATURE
Manuel Joseph`Duran
.0 i
Print Name
STATE OF FLORIDA
COUNTY OF
A CFnCTFT) RFF()RF A/M Pq 2 nAvo-u Sept eber
BY Manuel Joseph Duran Vfflo I
HAS PROVIDED
period.
"M!'\ I Z'...
DATE
S PERSONALLY KNOWN TO ME X , OR
TE OF FLORIDA, County of
�Z %�
SIGNAT[JRE OF NOTARY
AS IDENTIFICATION.
�41 wal I I
ixrA
Arjana Veneziano
NOTARY PUBLIC
STATE C F FLORIDA
f* Comm# GG! 85914
Expi r
es 2/1412022
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 234111111111111111111111111&-.65(%)] $175(penmit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014