HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VII2GINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1575
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2108-0645 ADDRESS: 7406 Lakeland Blvd. Fort Pierce, FL 34951
I Roberto Sanchez , 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 Delays in material availability
OWNER/BLDR/OR/C/ONTRA�CTO`R SIGNATURE
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Print Name
STATE OF FLORIDA
COUNTY OF
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ATE
ACKNO1yW/gL_E'DG,E(DLBEF (O'RE M' IE THIS �. � DAY OF �•Q. C,1 , 20 2-�
BY 1�?11fN t 1 D a O.WcyE� WHO IS PERSONALLY KNOWN TO ME � OR
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HAS PROVIDED
STAT Fes•' I otYC unTy f
SIG OF NO 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.
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�tA • • ' MY COMMISSION tF BN 144714
EXPIRES: September 1D, 2025
,�°`�_ Banded ThN Nc Undrn tellers
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Example: [IS divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014
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