HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982 RECEIVED
(772)462-1553 Fax(772)462-1578
OCT 3-0.2020
PERMIT RENEWAL REQUEST Permitting Department
St. Lucie County
PERMITNUMBER,,t;OJ n /,5 Z ADDRESS:rs-�� � 'r��1/11J /XI, Ups �o1Zl PJ2Jz4
I, Dei j QL r) ccSiY,,��t�Ti 6Z ,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 M L-IQ2 GnJ DE7L- f��
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Gil a O
OWNER/BLDR OR CONTRACTOR A RE DATE
AL
Print Name
STATE OF FLORIDA
COUNTY OF 5�r
ACKNOWLEDGED BEFORE ME THIS 3b DAY OF d 20 a•a
BY 6 n o+� �`��'�`` '^, T' WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED y-V L AS IDENTIFICATION.
. DEANNAMARIEGIVENS
STATE OF FLORIDA,County of S�' �^ C �Q 'gl• `= My COMMISSION#GG 022023
Po EXPIRES:December 16,2020
oWNIV Bonded Thru Notary PUNIc Underwriters
SIGNATURE OF NOTARY
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 7/21/2014