HomeMy WebLinkAboutPermit Renewals St LucieCOUNTY
F
L O R I
D ill
PLANNING AND D VELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772 462-1553 Fax (772) 462-1578
PERMIT NUMBER: 2007-0338
RENEWAL REQUEST
ADDRE�S: 6540 Zapote Ct
I Shyan Wojtczak
,am
understand that I must schedule and pass all requir
understand that this is a ONE TIME RENEWAL
passing inspection during any six month period du
Justification I thought it was already inspected
4uesting that the above permit be renewed. I
inspections for the permit to be finaled. Further, I
d the permit shall expire should I not receive a
g the renewal period.
12-14-21
R OR CQ3YR-ACTOR SIGNATURE I DATE
Shyan Wojtczak
Print Name
STATE OF FLORIDA
COUNTY OF `;jt . J tAC\&
ACKNOWLEDGED BEFORE ME THIS ,DAY OF
BY ��^^I(JE'(� (7 \` ,�( K WHO IS _
HAS PROVIDED
STATE OF O ACf 7X""/L
SIGNATURE OF NOTARY
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 = $
Example: [15 divided by 23=.65(%)] $175(permit fee) x
Revised 7/21/2014
20
Y KNOWN TO ME , OR
AS IDENTIFICATION.
Michael
Notary Public
SEAL a ' State of Florida
Comm# HH025672
ws�h I Expires 7/30/20V
fee
113.75 (renewal fee)