HomeMy WebLinkAboutPermit Renewal RequestST
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATION_ S DIVISION
2300 VIRGENIA AVE
FORT PIERCE, FL 34982
.R.E CEy E ®— I (772) 462-1553 Fax (772) 462-1578
JUN 0 8 2018
Lucie County, Permitting
PERMIT NUMBER: 1711-0371
PERMIT RENEWAL REQUEST
ADDRESS: 3006 Bent Pine Drive
I, James R. Brann , am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be fmaled. Further, I
understand that this is a ONE TEVIE RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification Pool company was delayed in getting the site ready for installation on of the
pool enclosure.
WNE LDR OR CONTRACTOR SIGNATURE
James R. Brann
Print Name
STATE OF FLORIDA
COUNTY OF St. Lucie
6-6-2018
DATE
ACKNOWLEDGED BEFORE ME THIS 166�:hb— DAY OF IJUrl--C , 20_LE
BY James R. Brann
HAS PROVIDED
ST TE OF FLORIDA, County of St. Lucie
SI ATURE OF NOTARY
FOR OFFICE USE ONLY:
WHO IS PERSONALLY KNOWN TO ME X , 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.
KRISTINE MICHELLE TAYLOR
=a _State of Florida -Notary Public
SE -* *= Commission # GG 155618
;"4' �e,� My Commission Expires
October 29, 2021
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014