HomeMy WebLinkAboutrenewalPLANNING 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: 191 1 -0069 ADDRESS: 7583 S OCEAN DR
I, JAMES F GRIMES 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 ex ire should I not receive a
passing inspection during any six month period during the renewal period.
Justification PERMIT EXPIRED 05/5/2020
c
R/BLDR OR CONTRACTOR SIGNATURE
JAMES F GRIMES SR
Print Name
STATE OF FLORIDA
COUNTY OF .S?- Lug e—
09/28/2020
DATE
ACKNOWLEDGED BEFORE ME THIS _,Zg bAY OF See. 20� Q
BY ��a� /, r� rh WHO PERS LY KNOWN Ty , OR
HAS PROVIDED
AS IDENTIFICATION.
STATE F FLORID , County of S
E-1
SUSAN MONTENEGRO
COMMISSION # GG 089099NATURE OF NO3SAEXPIRES:AprII2.2D2i
Thru Notary Public Undyr tm
------------------ ---------------------------------------- -------------------------------
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(pertnit fee) x .654113.75 (renewal fee)
Revised 7/21/2014