HomeMy WebLinkAboutPermit RenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 2001-0048
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 5841 HONEYBELL CT 36D, FORT PIERCE, FL 34982
I RICHARD BASSOFF '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 NEED TO REOPEN TO CALL FOR FINAL INSPECTION
RICHARD BASSOFF
Print Name
STATE OF FLORIDA
COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS 19TH DAY OF OCT
By RICHARD BASSOFF
HAS PROVIDED
10/19/20
DATE
2020
WHO IS PERSONALLY KNOWN TO ME X OR
Countyof PALM BEACH
FOR OIfFICE 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.
ERE
State of FbritlaeofgeacuSEALon GG 2331502022
Example: [15 divided by 23=.65(%)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/212014
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O R I D A"
PERMIT NUMBER: 2001-0048
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 5841 HONEYBELL CT 36D, FORT PIERCE, FL 34982
I RICHARD BASSOFF '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 NEED TO REOPEN TO CALL FOR FINAL INSPECTION
RICHARD BASSOFF
Print Name
STATE OF FLORIDA
COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS 19TH DAY OF OCT
By RICHARD BASSOFF
HAS PROVIDED
10/19/20
DATE
2020
WHO IS PERSONALLY KNOWN TO ME X OR
Countyof PALM BEACH
FOR OIfFICE 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.
ERE
State of FbritlaeofgeacuSEALon GG 2331502022
Example: [15 divided by 23=.65(%)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/212014