HomeMy WebLinkAboutPermit renewal01072021COUNTY
F
LORI
DA-44
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2006-0256 ADDRESS: 10200 S Ocean Dr 306
I, Luke Walker , 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 Needs final inspection
OWNER/BLDR OR CONTRACTOR SIGNATURE
Luke Walker
Print Name
01 /07/21
DATE
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS % T/ DAY OF '�,4A)'IgIZV , 20_
BY �64-4 4-1AZA 102 WHO IS PERSONALLY KNOWN TO ME V OR
HAS PROVIDED
STATE OF FLO
ILL✓
SIGN E OF >FffTARY
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
AS IDENTIFICA
SEAL
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014
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