HomeMy WebLinkAboutPermit Renewals PLANNING 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: SLC 2103-0237 ADDRESS: 7003 Belleair Ave'
I, Morey Doyle ,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
passing inspection during any six month period during the renewal period.
Justification COVID - Supplies and man power shortage
2/3/2022
OWNERBLDR OR CONTRACT IGNATURE DATE
Morey Doyle
Print Name
STATE OF FLORIDA
COUNTY OF Bre-rd
ACKNOWLEDGED BEFORE ME THIS 3rd DAY OF January ,2022
BY Morey Doyle WHO IS PERSONALTY TCN(1wN TO ME XXX OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA, u o B revard "Vier NNoatrP Da ate of Florida
IN Notary
My Commission HH 029010
Expires 08AW024
SIGNATURE OF NOTAR SEAL
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