HomeMy WebLinkAboutPermit renewal 01/16/2018 08:54 FAX 7724606929 _ WILC0 2001 .
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VLRGINIA AVE
FORT PIERCE,FL 34982
(773)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMITNUM13ER: 1701-0803 ADDRESS: 10701 S OCEAN DR 654
I, ROBERT WILLIAMS ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be flnaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I mot receive a
passing inspection during any six month period during the renewal period.
Justification We are reaching out in effort to have the above permit renewal due to our current load
• 1/16/2018
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
ROBERT WILLIAMS
Print Name
STATE OF FLORIDA
COUNTY OF ST LUCIE
ACKNOWLEDGED BEFORE ME THIS 16 I)AY OF JAN UARY
By ROBERT WILLIAMS WHO IS PERSONALLY KNOWN TO ME X ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLO CouptY of ST LUCIE
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FOR OFFICIE VISE ONLY:
Number of Open Inspections: Q a a
Total Inspections:
(Divide opera 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 7/21/2014
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