HomeMy WebLinkAboutPermit Renewal RequestJUL 2 1.2008
Public Works St. Lucie County, FL
Public Works Department
Code Compliance Division
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
PERMIT RENEWAL REQUEST
ADDRESS Ua . • PERMIT NO.: ® 0 S 0y dg
_,AM REQUESTING THAT THE ABOVE
PERMIT IS RENEWED FOR EIGHTEEN MONTHS. 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. -
owner/Builder or Contractor Signature Date'
STATE OF FLORIDA
COUNTY OF
Swom to and subscribed before me this a/ day of 200�
by }�{ ��A(�- nj /-- ho is personally known 'orwbo has produced
r) A, %2 = as identification. 177 V/P O • /�� . , �� fj • v
Notary Public, State of Florida
� o
Signature of Notary;
Commission No.: (Seal)
FOR OFFICE USE ONLY:
RENEWAL FEE:
OPEN INSPECTIONS l ) X PERMIT FEE ($ R� ) a $ ob
TOTAL INSPECTIONS ( )
AUDREY B. HUMPHREY
MY COMMISSION A DD U3047
tlPIRES; March 6. 2011
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