HomeMy WebLinkAboutPermit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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PERMIT NUMBER: 1909-0085
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 8750 S OCEAN DR 636, JENSEN BEACH, FL 34957
I Jonathan Starratt , 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 glass backordered, homeowner out of state -no access to property
OWNER/BLDR OR
Print Name
STATE OF FLORIDA
COUNTY OF Martin
SIGNATURE
ACKNOWLEDGED BEFORE ME THIS 15
BY Jonathan Starratt
HAS PROVIDED
STATE OF FLORIDA, zCt of Martin
SIG AT RE OF 0'I ARY
FOR OFFICE USE ONLY:
DAY OF October
/O—IS-2v
DATE
,0 20
WHO 1S PERSONALLY KNOWN TO ME X , OR
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.
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State of Florida
lesn GG 235102SEAL2022
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014