HomeMy WebLinkAboutKleinPermitRenewal.......................
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578
PERMIT NUMBER: SLC- 2102-0048
PERMIT RENEWAL REQUEST
ADDRESS: 12772 Nw Mariner Ct
I Robert Crane , 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 Generator was backordered
OWNERBLDR OR CONCOACTOR SIGNATURE
Robert Crane
Print Name
9/20/2021
DATE
STATE OF FLO
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS N DAY OF - 20 L
BYVC V l& WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED
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
AS IDENTIFICATION.
n �, Not," Public State of Florida
,'y Angela Staples
M < Y My Commission GG 235102
SEA 10 11� Expires 07/04/2022
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014