HomeMy WebLinkAboutPermit Renewals 11-09-'17 11:48 FROM-G&G Hoofing 3213014471 T-381 P0002/0003 F-642
_ M PLANNING AND DEVELOPMENT SERVICES DIEpAIRTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VTR ;yt
>�oRr rllERCEc>v,F 349 349
(772)467-1553 F"012)4
PERMIT RANE`1X'AL REQUEST N O'/ 9 ";7
Permitting Department
St. [_ucie County, FL
PERMIT NUMBER: 1 703-0243 ADDRESS:4100 N A1A
](, Raymond Smith .aln requesting that the above permit be renewed. r
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 sax month period during the renewal period.
Justification Please need a renewal for this commercial job that has taken a little longer than expected.
i
11/912017
OWNERIBL R ONT GNATURE bATL
t
Raymond S
Print Namo
STATE OF FLORIDA
COUNTY OF Br6vwd
ACKNOWLEDGED BEFORE ME THIS 9 DAY QF November Zp 1�7�
$y Raymond Smith WHO IS PERSONALLY KNOWN TO ME V ,OR
HAS PROVIDED AS IDENTIFICATION.
OIL TDA,County of Brevard DALANNIE RAYF-KHOURY
NOTARY PUSUC
STATE OF FLORIDA
IGNA RE OF AR Se CornnW FF114072
0 FUpires 4/17/201 B
]FOR OFFICE USIE ON1LY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original pennit fee: x%open = S\adO.a ciRenewal fee
Example: (15 divided by 23=.65(1/o)] $175(perniit fee)x.65=;S113.75(renewal fee)
Revised 7/21/2014