HomeMy WebLinkAboutrenewalPLANNING 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 2105-0168 ADDRESS: 9950 S Ocean Dr
I Pavel REdko , 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 Material shortage cause CX not to be complete. Please renew in order for inspections/permit closure
SIGNATURE
Pavel Redko
Print Name
STATE OF FLO�
COUNTY OF
2/15/2022
DATE
ACKNOWLEDGED BEFORE ME THIS 15471 DAY OF OA-t-u( 20 t2l
BYav& WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDEDAS IDENTIFICATION.
STATE OF FLORIDA, Cou o
SIGNAT RE OF NOT��v N' Notary Public State of Florida
t� Kristee Nelson
N.1�k
A_ .,• My Commission HH 059433
SEA or*,Expires 11/02/2024
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