HomeMy WebLinkAboutPermit Renewal Request_2005-0687_4-7-21 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
i - Ao-11 BUILDING AND CODE REGULATIONS DIVISION
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2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-15.53 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2005-0687 ADDRESS: 2950 Aico Road, Fort Pierce, FL 34951
Dan Curington, Curington Contracting, LLC 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 This permit needs a final inspection so it can be completed.We would like to
renew the permit so we can have this done. Thank you.
4-7-2021
RIBLDR_CONTRACTOR SIGNATURE DATE
�DCtn
Print Name —�
STATE OF FLORIDA
COUNTY OF,QL/JJ A)
ACKNOWLEDGED BEFORE ME THIS—76—DAY OF HfiQI L .20—;�I_
BYUAMA) WHO IS PERSONALLY KNOWN TO ,OR
HAS PROVIDED AS IDENTIFICATION.
STATE O 1 only /)
Notary Public Stele of Florida
Michael Bruzdziak
+� My Commission GG 254695
OTA SEAL '4ptV Expires 09/03f2022
---------—__-_---------_--__—__---_,------------------------------------ —_---____--____-_____
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: [15 divided by 23=.65(%)I $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/212014