HomeMy WebLinkAboutPermit Renewal Req (Ahmed) PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
— FORT PIERCE.FL 3498E
(772)462-1553 Fax 1772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1905-0713 ADDRESS: 7875 Saddlebrool( Dr
Cheyenne Ellison ,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 peril shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification Still need to finish final & get inspected
6/18/21
O B DR OR CONTRA RSIGNATURE DATE
Cheyenne Ellison
Print Name
STATE OF FLORIDA
COUNTY OF a-
--ACKNOWLEDGED BEFORE ME THIS 18 DAYOF dune 2021
BY Cheyenne Ellison WHO IS PERSONALLY KNOWN TO ME X .OR
HAS PROVIDED AS IDENTIFICATION.
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SIGN AT�[OLy1J SEALy -Wodt2/t1Yla22
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%ofopen inspections)
Percentage:
Original permit fee: x%open = S Renewal fee
Example: [15 divided by 23=.65(%)] S175(permit fee)x.65=SI 13.75(renewal fee)
acvimd 7121/1014