HomeMy WebLinkAboutPermit RenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMITNUMBER: SLC 2009-0617 ADDRESS: 11103 Muller Rd
I Robert Donovan , 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 Re -Roof not completed in time due to Covid.
OWNERBLDR _ CONTRACTOR SIGNATURE
Robert Donovan
Print Name
STATE OF FLORIDA
COUNTY OF Palm Beach
ACKNOWLEDGED BEFORE ME THIS 12th DAY OF
BY Robert Donovan
HAS PROVIDED
FOR OFFICE USE ONLY:
7/12/2021
DATE
zo 21
WHO IS PERSONALLY KNOWN TO ME X OR
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
AS IDENTIFICATION.
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MYcoMMISSION#GG930883
SEAL -�t,ioi EXPIRES: Match 10, 2024
Bonded Thm Notm Public Undaiwri63r5
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Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014