HomeMy WebLinkAboutPermit Renewals From 3218061779 1.321.806.1779 Fri Oct 5-12:36:23 2018 MDT Page 3 of 13
•
[OCT 0 9 2018
RECEIVED
cie CnuntY, Permitting
10-05-'18 14:30 FROM-G&G Roofing 3213014471 T-705 P0003/0010 F-206
PLANNING AND)DEVELOPMENT SERVICES DEPARTMENT
m ` BUILDING AND CODE REGULATIONS DIVISION
CbONTY 2300 VIRGINIA AVE
FORT)PIERCE,FL 34982
(772)462-1553 Fax(172),162-1578
PERMIT RENEWAL REQUEST
j1PRMIT_NUMBER:-SLC 1703-0246 ADDRESS,4100 N A1A Project Bldg
L Raymond N.Smith II ,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-tha.Fthis-is.;aDNE TIM&-R RNEWAL_and_the peamit.shalLexpire�sl�ntrld I not receive a---.- w
passing-inspection. uring any six month perioci cluringrc renewal period. -
justifteation delay on materials,and bad weather
10/05/18
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
Raymond N.Smith II (Contractor)
Print Name
STATE OF FLORIDA
COUNTYOF_6gjgVjL
ACKNOWLEDGED BEFORE ME THIS 5 DAY OF �� 20 ,
BY? iL.f111C7f1U' GM>,��WHOISPERSONALLY KNOWN TOAfr OR
HAS PROVIDED AS IDENTIFICATION.
STATE RJDA,County of JrGVO— 05ELAKELLY
� NakryPublk�5tateofFlotfda
F
Commission a eGt)b)76t
SIGNAT NOTARY or.n,,o+s h1 Comm
i SEAL. `' Y EspretApr3,102t
�dedthragM1Na6ona1NplalyA�sR
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: [l5 dividcd by23-.65(%)) S175(petmit fee)x.654113.75(renewal fee)
Rnv1s.d 7/21/2014