HomeMy WebLinkAboutPermit Renewal Request Falanga7 s�
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aI, Janet Mluci
understand that I mL
understand that this
assing inspection d
ustificatione a
GPL B TI IOG,W� L ISIONTME
402300 VIRGINIA AV
1 ORT PIERCE, FL 349
(772)462-1553 Fax (772)462-157
PERMIT RENEWAL REQUEST
'LC 2105-0664
schedule and 1
a ONE TIME
ina anv six mo
7TI:E
%PQjf SS: 9900 S. Ocean Dr. #1505
, am requesting that the above permit be rene I
all required inspections for the permit to be finaled Further
KEWAL and the permit shall ex .
)eriod during the renewal period.
3-8-22
L 14TRn SIGNATURE DATE .
Janet Milici
EPrint Name •
ee
STATE OF FLORID
COUNTY OF Martin
13Y *EDGED
MKici
• I O DED_
s % Y F Marc",� r W022
Aw
HO 1 PERSONALLY KNOWN T XX R
� T TE OF FLORIDA, Co ntyMARTIN.
SIGNATURE NO AR
FOR OFFICE USE
Number of Open Inksec
Total Inspections:
. (Divide open by total to
Percentage:
Original permit fee:
d
aLw"6Rcv iscd 7/21/2014
of open
x I! open = enewa ee
2"° 75 ermit fee) x 5= 113.75 renewal fee
mar �N Notaiy Public State of Florida
i � Donna Jayne Hail
My Commission GG 2075fl5
rya ,d Expires 04/15/2022