HomeMy WebLinkAboutPermit Renewal RequestMar. 28. 2018 1:02PM
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No.7158 P, 2
PLANNING AND DEVELOPMENT SERVICES DEPARTMEEN
BUILD)NG AND CODE REGULATIONS DIVISION
PERMIT NUaER: l i L>&— U 3 ei )
2300 VIRGD41AAVE
FORT PIERCE, IFIL 34932
(772) 462-1553 Fax (772) 462-1578
1P'ERMT RENEWAL REQUEST
RECEIVED
MAR 2 9 2018
I ST. Lucie County, Permitting
ADDRESS: -7 J17C7 � . QCea.n ORrU e.
'.1 L , am requesting that the above permit be renewed. I
understand th t I must schedule and pass all required inspections for the permit to be finaled: Further,
understand that this is a ONE TIM RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month, period during the renewal peribd-
justification -rhe— home, i:� u delz /'ondr. 1,uao% r"s tje,0Z �urJ/
61ceL7rreJ1'4,=/If L�lI'//. 44e �on,edb
OWNE Q$ CO TIUWftSIGNATURE DATE
a rr�/ Ai A
print Name
STATE OF FLORIDA
COUNTY OF ' _t 1-e1 AV r /C
ACKNOWLEDGED BEFORE ME THIS o�'� DAY OF A .1 h 20-2-L—
WHO IS PERSONALLY KNOWN TO ME OR
IVICIRV {AVID01
/. 06 4i:�WOCOOANII[C1A
STATE OF FLORMA. Co of MILES- MILLS
Commission OFF 2MB5
My SIGNA OF NOTARY SEAL eem moron EDprres
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections. � 41__
(Divide open by total to get % of open inspections)'
Percentage: ,, c? &
Original permit fee: ',75. c o x % open = $ Z2Z3- SO Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65-$113.75 (renewal fee)
Revised 7/21/2014