HomeMy WebLinkAbout0025 Bergeron - Dry Wall Permit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 2012-0406
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 607 Brack Road
I James Foster , 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 MASSIVE personnel issues due to COVID and shortage of materials. We
need to request an extension to allow us time to complete the work on this permit.
08/24/21
O R/BLDR OR CONTRACTOR SIGNATURE DATE
James Foster
Print Name
STATE OF FLORIDA
COUNTY OF Okaloosa
ACKNOWLEDGED BEFORE ME THIS 24th DAY OF August , 2021
BY James Foster
HAS PROVIDED
WHO IS PERSONALLY KNOWN TO ME X , OR
AS IDENTIFICATION.
OF FLORIDA, County of UKaioo50
O ��� g .>U CAROL A PORTAL
�:^ Notary Public -State of Florida
t� - Commission 339233
CURE OF NOTARY y �o My Comm. Expires 05-28-2023
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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 = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014