HomeMy WebLinkAboutGreg Brown - Savannas State Park (St. Lucie) - Permit Renewal RequestPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
COUNTY
J BUILDING AND CODE REGULATIONS DIVISION
. R I D A 2300 YIRGEWA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER. 2 1 O5-O 1 O5 ADDRESS: 9551 Gumbo Limbo Lane, Jensen Beach 34957
1, James Player am requesting that the above pennit 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 Delaves due to GOVID - loaistic issues with components
-7/ z o z 2
OWNERIBUOk OR CONTRACTOR SIGNATURE DATE
James Player
Print Name
STATE OF FLORID
COUNTY OF Rra ford
ACKNOWLEDGED BEFORE ME THIS 1 7th DAY OF March 20 22
BY James Player WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
ST�OF RIDA, Coca �
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Commission # GG 362849
IGNA NOTARY SEAL Ex*sAugu$125,2023
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
Example: (15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/2112014