HomeMy WebLinkAboutPermit Renewals 0412612018 10:54 TAX) P.0011002
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
-- --- FORT PIERCE,FI.34982 �
(772)462-1553 Fax(772)462-1578
RECEIVED
1?ER1vIIT RENEWAL REQUEST APR 2 6 201b
Permitting Department
St. Lucie County
PFIZMT NUMBER; 1703-0517 ADDRESS. 12132 Riverbend Rd. Port St.Lucie, FL
I, Elite Gas Contractors/Propane Services am requesting that the above permit be renewed_ I
understand that I must schedule and pass all required inspections for the permit to be fmaled. Further,I
understand that this is a ONE TIME RENEWAL and the permit shall expire should X not receive a
passing inspection during any six month period during the renewal period.
Justification All work has been completed, needs to pass a final inspection.
04/25/2018
OWNER/BI. CONTRACTOR SIGNATURE DATE
Cheyenne Ellison
Print Name
STATE OF F'LOR
COUNTY OF ill
A CKNO WLEDCxED BEk ORE ME THTS DAY OF 20
BY WHO IS PERSONALLY KNOWN TO ME .OR
HAS?POVIDED AS IDENTIFICATION.
S TA70ORMA,Co.tut of_�{, ,,o P Notary Publ,c Stated Fionda
r �� % L*Cey L R1=9
11 My Commission GG 188732
SIGN RE OF TARX 3EAI. ��a pp� Exoms 12/17/2021
l+0)Ei 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: 1[I$divided by 23=.65(%)] $I75(permit fee)x_65=$113.75(renewal fee)
Revised 7/212014