HomeMy WebLinkAboutPermit Renewal requestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
COCI N�3OR
PERMIT NUMBER: 2010-0178
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 7380 S Ocean Dr 919A
I Peter A Cafaro I I I , 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 TEME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
This pe"it is expired, still needing final done.
SIGNATURE
Print Name
STATE OF FLORIDA
COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS 29
BY Peter A Cafaro III
HAS PROVIDED �_I_ 0 L—
STA
um
FOR OFFICE USE ONLY:
DAY OF November
11/29/21
DATE
2021
WHO IS PERSONALLY KNOWN TO ME x , OR
Nurnber of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
AS IDENTIFICATION.
MITCH BOCOOK
" 'XAIMy COMMISSION # HH 020560
EXPIRES: July 25. 2024
k3o2ded TTrru Notary Pub!ic Underwriters
Example: 115 divided by 23=.65(%)I $175(perinit fee) x .65=$113.75 (renewal fee)
ttevisW 7/21/2014