HomeMy WebLinkAboutpermit renewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 2106-0089
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIMA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
ADDRESS: 7121 Maidstone Dr. Port St Lucie, FL 34986
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
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OWNERBLDR OR CONTRACTOR SIGNATURE DATE
Roberto Sanchez
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDG[E�D BEF(O�RE ME THIS
\� DAY
OF Ma✓
20 � C—
BY
� .P-(�p � �D.NC�'L..
WHO
IS PERSONALLY KNOWN TO ME
�_
OR
,
HAS PROVIDED
STA F-F oun of
SIGNA OF OTARY
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.
JONAI'HON7HOMAS
MY COMMISSION # HH 144714
g�}{�RES: September 18, 2026
Example: [15 divided by 23=.65(%)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/21/20I4