HomeMy WebLinkAboutPRMT RENWL REQ 1920 ROYAL PALM DR #SLC 2002-0726tLUNTY
O R 1 Q A
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: SLC 2002-0726 ADDRESS: 1920 ROYAL PALM DR
1 EdWARd LECHNER (EDIFICIUM CONSTRUCTION, LLC) 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 NEED TO REVISE PRODUCT APPROVAL TO: METAL SALES MANUFACTURING CORP
5V METAL(FL 40264) AND HAVE FINAL INSPECTION.
G)
OWNER/BLDR OR CONTRAC R SIGNATURE DATE
EDWARD LECHNER
Print Name
STATE OF FLORID , ,
COUNTY OF L A) t CA
ACKNOWLEDGED BEFORE ME THIS 1Y DAY OF Mlt Q C- 17 120
�r
BY C 6 r WHO IS PERSONALLY KNOWN TO ME �, OR
HAS PROVIDED
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.
�or •y Notary Public State of Florida
David E Mixon
SEAL �< Svey Comm ssien HH 057358
+'wor�dl Expires 0212412W5
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014