HomeMy WebLinkAboutPERMIT RENEWAL REQUEST i
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIN1 111 AV)C
FORT PIERCE,FL 34982
(772)462-1553 F21X(772)462-1578 RECEIVED
PERMIT RENEWAL REQUEST MAR 16,2022
St.Lucie County
Permitting
PERNIIT NUMBER: V � ADDRESS:
I> l ` I ,aril requesting that the above permit be renewed. I
undelrstand that I in 1st schedule and pass all required inspections for the perrrtlt to be finialed. kurther, Z
understand that t pis is a ONE TJME RENEWAL and tha ,permit shall expire should I not receive a
passing inspection c unng any six month period during the renewal period.
Justification I G is I r
OWNER/BLDR R CC NT ff O A' E DAT
J a A
Print Name f
STATE OF FLOR DA
COUNTY O � f
ACKNOM-6DOED B. F RE ME THIS DAY OF (i1ti Zp
BY i a' ` - I V�I.G HO IS PERSONALLY KNOWN TO ME�JZ
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HAS PROVIDED I AS IDENTIFICATION.
S ATE OF FL I A,Con f 06 tar Public$take 01 Florida
.w, v:mny
XceneNewman
Fran
SIGNATI EOFN R MyCOtnmission GG 22i43a
L�xPires 05123l2022
FOR OFFICE USE ON. Y:
Number of Open Xnspecti ns:
TotaI Inspections.,
(Divide open by total to %of open inspections)
Percentage:
Original permit fie: x%open = 5 Renewal fee
Example: (15 divided y23=.65(%)1 $I75(pelmit fee)x .65=$113.75(renewal fee)
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Revised 7/21/24I4