HomeMy WebLinkAboutPermit Renewal Nov 23 2021 3:45pm Ada 3052434613 p,1
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
• - BUILDING AND CODE REGULATIONS DIVISION
` - 2300 VIRGINIA AVE
FORT PIERCE,FL 34982 MCENED
(772)462-1553 Fax(772)462-1578
NOV 2 3 2021
PERMIT RENEWAL REQUEST St.Luaidoanty
PaTelhing
PERMIT NUMBER. 2002-0450 ADDRESS: 9675 RANGE LINE RD
I, Michael P. Donnelly ,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 completed Fire Alarm final inpsection on December 16, 2020. We
were under the impression that inpsetion closed out our permit.
September 20, 2021
OWNER/BLDR OR CONTRA �ORSI�GXATURE � . DATE
Michael P. Donnelly
Print Name
STATE OF FLORIDA
COUNTY OF Miami Dade
ACKNOWLEDGED BEFORE ME THIS 20 DAY OF September 2021
BY Michael P. Donnelly WHO IS PERSONALLY KNOWN TO ME 'OR
HAS PROVIDED AS IDENTIFICATION.
DATUREOFNO
OFFLO A, o Y.pMiami Dade
Andy Cala
j^ �^ NOTARY PIJSLIC
T •.e1 �STATr OF FL
CiRiDA
SEAL G-, �� o
Commit GG1673'23
E Expires 12/29/2021
FOR OFFICE USE ONLY:-------------------------------------------------—------
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Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Orin-inal nennit fPP• of _