HomeMy WebLinkAboutFinley Permit ExtPLANNING 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
PERMIT NUMBER: 2104-0490 ADDRESS: 8053 S. Indian River Drive
I, Robert S. Crane , 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 ONETIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification generator was backordered. Installation scheduled for early February
OWNERS DR_ CON CTO GNATURE
Print Name
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DATE
STATE OF FLORID
COUNTY OF \a_i_ )
SA
ACKNOWLEDGED BEFORE ME THIS ' DAY OF 120
BY �) ai6O IS PERSONALLY KNOWN TO MF OR
HAS PROVIDED
AS IDENTIFICATION.
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mcr Notary Public State of Florida
Angela Staples
SEAL My Commission GG 235102
Expires 07;04/2022
_.__------------_-----_----------------------_-------- —----- ------ ----------------- ---------
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 = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014