HomeMy WebLinkAboutPermit Renewals �-—mac _��^ �•...
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND,CODE REGULATIONS DIVISION
- 2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax 772 462-1578
I
PERMIT RENEWAL REQUEST AI'
PERMIT NUMBER: SLC 1901-0546 ADDRESS: 6375 S US HIGHWAY 1
L Stanley Maclin am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be fmaled: 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 MasTec Network Solutions would like to request an extension for the above referenced
permit due to a delay in receiving back ordered equipment to complete the proposed work
5/1 W20
OWNERIB D OR CONTRACTOR SIGNATURE DATE
Stanley Maclin
Print Name
STATE OF FLORIDA
COUNTY OF st Lucie
ACKNOWLEDGED BEFORE ME THIS 13 DAY OF May 20 20
BY Stanley Maclin WHO IS PERSONALLY KNOWN TO x OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLO County of ST.:LUCI2 "ra
=otP� r'e•, YANET RODRIGUEZ
Notary�( Y Public-State of Florida
Commission d GG 3Z5980
SIGNATURE F TARY SEAL °F .• My Comm.Expires Apr 21,2023
Bonded through National Notary Assn.
-------------------------------------------------------------
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(permit fee)x.65=$113.75(renewal fee)
Revised 7/21t2014
I `�•zs•Z�- G-V ivy. U�l�e� �nt��� ��, - .