HomeMy WebLinkAboutPermit Renewal PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
- FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 4624578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: SLC 2002-0358 ADDRESS : 7106 Georges Rd , Ft Pierce
I Roberto Sanchez , 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 In order to schedule final inspection
r � /
OVdNER/BLDR OR CONTRACTOR SIGNATURE DATE
Roberto Sanchez a & Aafon Hallich
Print Name 'iFNOTARYPUBUC
?~ STATE OFFLORIDA
Comm# GG951577
°j4Cc 19�0 Expires 1 /27/2024
STATE OF FLORIDA
COUNTY OF /TX
ACKNOWLEDGED BEFORE ME THIS Y DAY OF /✓G+L. 20
BY TO ME , OR
HAS PROVIDED // AS IDENTIFICATION.
STATE OF FLORIDA, County of K
SIGNATURE OF NOTARY SEAL
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 = S Renewal fee
Example: ( 15 divided by 23=.65(%)] S175(permit fee) x .65=$ 113 .75 (renewal fee)
Revised 7/21/2014
Ic�jSIS1/