HomeMy WebLinkAboutrenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
'; jj - BUILDING AND CODE REGULATIONS DIVISION
•
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: SLC2105-0061 ADDRESS: 1801 N 31ST ST, FORT PIERCE, FL 34947
I SCOTT BERMAN , 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 PERMIT EXPIRED WHILE WAITING ON MATERIALS FOR INSTALLATION FROM
MANUFACTURER. WE ARE NOW READY TO PROCEED WITH INSTALLATION,
O WNER/BLDR
SCOTTBERMAN
Print Name
STATE OF FLORIDA
COUNTY OF SAINT LUCIE
SIGNATURE
ACKNOWLEDGED BEFORE ME THIS 9TH
BY SCOTT BERMAN
HAS PROVIDED
02/09/2022
DAY of FEBRUARY
DATE
WHO IS PERSONALLY KNOWN OR
TE OF FLORIDA, county of SAINT LUCIE
Y
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
AS IDENTIFICATION.
O�,pY P� Notary Public State of Florida
? Jennifer S. Fettes
SEAL ;� ,._ < My Commission GG 218215
�iEof� Expires 05l15/2022
Example: [ 15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014