HomeMy WebLinkAboutrenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 2101-0643
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 13 Majestic Way Hutchinson Island, FL 34949
1, Zero Degrees Cooling and Heating LLC 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 Scheduling was complicated and wasn't able to finish the job
L
OWNERIBLArOR CONTRACTOR SIGNATURE
Condane Rolle
Print Name
STATE OF FLORIDA
COUNTY OF st Lucs
ACKNOWLEDGED BEFORE ME THIS 4th DAY OF Feb
BY Condane Rolle
HAS PROVIDED DL
FOR OFFICE USE ONLY:
02/04/2022
DATE
2022
WHO IS PERSONALLY KNOWN TO ME . 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.
�r r Notary Public State of Ronda
SEAL Gregory Freeman
MY Corrunisvon GG 966056
�q�o E.P,res04I04R02a
Example: [15 divided by 23=.65(a/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014