HomeMy WebLinkAboutPermit Renewal RequestOct/10/2019 2'49'39 PM _ Center State Bank Vero Beech 772-257-3743 _ 2/2
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
3300 VIRGINIA AVE
FORT PIERCE, FL 34992
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
P.ERMITNUMBER. SLC 1705.0335 ADDRESS; 251 N. Cardinal Place
I Michael zabitosky
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 RE X WAL and the permit shall expire should I not receive a
passim inspection during any six mon 1 period during the renewal period.
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Justification
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Michael Z-abitosky
Print Name
STATE OF FLORIDA �}
COUNTY OF . t -Lilt! f'Sybr
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10/9/19
DATE
ACKNOWL_EiDOEL7CI:, BEORME THIS q 4A DAY o ,a L+--bk1- 20—LA—
BY . M (:,i'1061 _ �{� 1 f� WHO I5 PERSONALLY KNOWN TO ME . OR
1:IASPROVIDED , Drws L1Cwe. AS IDENTIFICATION.
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ST TE OF FC.ORIDA, County of 7T G+t JQr1 p triltr
JENNIFER J wo005
f Rotary PUWIC - State vt Florida
Si OI? OTARY STsAL `� � / Commission • t GG 397196
My Comm, Expires Jul 22, 2023
FOR OFFICE USEONLY:
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 .654113.75 (renewal fee)
Revind7/21/2014