HomeMy WebLinkAboutA2P0036B RenewalA2P0036B
PLA\\ I NG A\D DE\.ELOPME\.T SE RVICES DEPART}I E\T
J BUILDING AND CODE REGULATIONS DIVISION
2fOO VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fr\ (772\ 462-1574
PER\IIT RE\E\\'AL REQUEST
pERMrr NUMBER SEC2104-0921 aoon;ss. 1100 Dyer Rd
1. Laura Zollinhofer , am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspcctions for the permit to be finaled. Further. I
understand that this is a ONE TIMf, RENE\ilAL and the permit shall expire should I not receive a
passmg lnspec
Justification E
on during any six month period during the renewal period
nsion is needed because the materials for construction were delayed c
supply ue
OWNER/BL NATURE DATE
ERICSSON, INC / Steve Nichols
Print Name
STATE OF FLORIDA
cowry op LAKE
ACKNOWLEDGED BEFORE ME THIS
BY STEVE NTCHOLS
HAS PROVIDF]D
lD ,o"o. t=t . zo22
wHo Is PERsoNALI-Y xNowN ro Nas H ,ot
AS IDENTIFICATION
S LAKEATF FLO Cougty of
S]ATURE O OTARY
CouNTv
f LO R I D A
RACTO
FOR OFFICE USE ONLY:
Number ofOpen lnspections: _
Total lnspections
(Divide open by total to get % ofopen inspections)
Percentage
Original permit fec x%open = $Rcnewal fee
Example: [l5 divided by 23:.65(%)] $ 175(permit fee) x .65=$ I t 3.75 (renewal fee)
Revis€d 7/21,2014
i/
SEAL