HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES,DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
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--- -- FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2103-0921(395) ADDRESS: 2528 N 38th AVE
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(CHARETTE RESIDENCE)
I, T xy 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 We are requesting an extension of 90 days. This is a piling pool and we are unable to
begin our project until the builder's work is completed.
OWN OR CONT OR SIGNATURE DATE
James T Leonard
Print Name
STATE OF FLORIDA
COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS 2nd DAY OF November 120 21
BY James T Leonard WHO IS PERSONALLY KNOWN TO ME XX ,OR
HAS PROVIDED AS IDENTIFICATION.
ST OF FLO Countyof t Lucie
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' �.'•: ANGELA BOR5001•BIRMI]Florida
�; Natary Piiblit State ofCommission#GG24SIGN RE OF NOT My Comm�Expires Aug 1
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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(0/o)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014
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