HomeMy WebLinkAboutPermit Renewals 05/07/2018 12:44 FAX 7724606929 WILCO 2001
.PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DMSION
2300 ViRCHNIA AVE
FORS'PIERCE,FL 34982 RECEIV E CD.
(772)462-ISS Fax(772)462-I5721
PENT RENEWAL REOVES MAY O 7 2018
ST. Lucle County, F'tzrmitting
PERMIT NUMBER 1705-0062 ADDRESS: 113 QUEEN ANN CT'
I, ROBE RT-VVILLIAMS am requesting that the above permit be renewed. I
understand that i must schedule and pass all required inspections for the perni t to be finaled. Further,l
understand that this is a ONE TI- RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification JOB WAS DELAYED DUE TO 2017 HURRICANE IRMA
5-8-2018
OWNER/BI:DR OR CONTRACTOR SIGNATURE DATE
ROBERT WILLIAMS
Print Name
STATE OF FLO!!
COUNTY OF _
ACKNOWLEDGED BEFORE ME Tldis `77 _AAY OF ' nag ,20
BY Q� � WHO IS PERSONALLY KNOV*N TO IVIE ,OR
1-W PROVIDED AS IDENIUFICATION.
STATE OF FLO Gounty of �� Law,'
'0 r DAWN F(f2GERACp
S 1(JRE OF O7 b11'COMMISSION O GG IOM
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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 = $lU Renewal fee
Example,' (15 divided by 23=.6$0/a)] $175(permit fee)x.654113.75(renewal fee)
Revised 7/21/2014