HomeMy WebLinkAboutPermit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
PERMIT RENEWAL REQUEST
nI ,,
PERMIT NUMBER: ADDRESS: f Z'4 C2��
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 TIME RENEWAL and the permit shall expire should I not receive a
nassing inspection during anv six month Deriod during the renewal period.
STATE OF FLORIDA
COUNTY OF � Z Ue':e
ACKNOWLEDGED BEFORE ME THIS DAY OF 4 b Y 20—ft
BY
HAS PROVIDED
FOR OFFICE USE ONLY:
WHO IS PERSONALLY KNOWN TO ME N , OR
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.
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MMYCOMSSION � iG 2T50
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Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014