HomeMy WebLinkAboutPermit Renewal Request -2ND REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 1912-0536
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIMA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 123 Queen Frederika Ct
1, James Brann , 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 Waiting on pool company to complete the pool deck so the enclosure can be
installed and inspected
OWNER/1 DR OR CONTRACTOR SIGNATURE DATE
James R. Brann
Print Name
STATE OF FLORIDA
COUNTY OF St. Lucie /d
ACKNOWLEDGED BEFORE ME THIS oV DAY OF Y7 / 20
BY James R. Brann
HAS PROVIDED
WHO IS PERSONALLY KNOWN TO ME X OR
AS IDENTIFICATION.
ST EOFFLORIDA ,Coun of KRISTINEMICHELLETAYLOR
State of Florida -Notary Public
*_= Commission # GG 166618
NATURE OF NOTARY SEAL ';"� FFoecr My Commission Expires
Piu 0 October 29, 2021
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(%)j $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014