HomeMy WebLinkAboutPermit Renewals PLA1V'>\'111G AND nEVELUPIViFNT SERVICES nFpARThiFNT
4�. BUILDING AND CODE REGULATIONS DIVISIph
1100 VIRGI!NIA AVE
FORT PIF.RCF,'l:l.34982
RECEIVED (772).462-1553 FYx:(772)462A578
OCT 0 6 2020
PERMIT RENEWAL REQUEST
ST. Lucie County, Permitting
100 —O PERMIT NUMBER: 9 3 S ADDRESS: .l aL 3_ oL r�>4�3a> �. �. i?E 13L"v�0,;
�
— ,am'requestingthat the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be.fmaled. Further, 1
understand,that,th s.is a ONE TIME RENEWA'L.and the.perm it shall expire should I:not receive a
passing-inspeetion during any six month period dui ing-the renewal period:
Justification
/Q^Z Zv
O LDR OR CO TRACTOR SIGNATURE DATE.
Print Name
STATE OF FLORID
COUNTY OF V.Glei
ACKNOWLEDGED BEFORE ME THIS vZ; DAY Of QC.��� ,20: Z
BY C��'( + �� JT.ri �" WHO I5 PERSONALLY KNOWNTO'ME OR
HAS PROVIDED AS IDENTIFICATION.
STA F N�'L ....DA,Co .y of ��ar�U,.,
SH IRLEY A.SAUNTER
— :}o��. fit,% Not Pualle•$tsto of Florida
4 Commission#GG 061648
� My'Comm.Expires dm 31,_2021
%; Banded thtaugh N*144 BWuY Assn,
SiGNA R OF OTA Y $E¢t '
FOR OFFICE USE ONLY:
Number of 0pen,Inspeclions
Total Inspections: N
(Divide open by total to get%of open inspectrons)
Percentage: b
Original lierrniffee:. x%:open 5.
Renewal fee
Example: [Y5 divided by 23=.65(%)] SI75(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014