HomeMy WebLinkAboutrenewal letterPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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COUNTYBUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT NUMBER: 1909-0464
PERMIT RENEWAL REQUEST
ADDRESS: 7380 S OCEAN DR, JENSEN BEACH, FL 34957
1, Jonathan Starratt am requesting that the above permit be renewed. I
understand that I must schedule and pass al 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 revision needs to be submitted -changing manufacturer on 1 opening per customer
-2-202_C)
OWNERIBLD R C #'k,7CT�ORSIGNATURE DATE
Print Name
STATE OF Fi.ORI
COUNTY OF ( NV
ACKNOWLEDGED BEFORE ME THIS L- DAY OF 20 d—V
BYj()nQfjjC,WHO IS PERSONALLY KNOWN TOME OR
HAS PROVIDED
S'1'; 'E OF FL [DA, Caunt�
S!GNM'UR# 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 = $ Renewal fee
AS IDENTIFICATION.
Ft",
Notary Public State of Florida
Angela Staples
R s My Commission GG 235102
Expiras U710.117G22
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014