HomeMy WebLinkAboutPermit Renewal RequestPLANNING 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: 1610-0220 ADDRESS: 3050 NW Radcliffe Way, Port St Lucie, FL
1, Joseph Holston , 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 Fountain Blue Pools needs to schedule final inspections to final out the permit.
11-1
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11 /15/2017 C"
OWNER/BLDR OR CO T TOR SIGNATURE DATE
Joseph Holston
Print Name
STATE OF FLORIDA
COUNTY OF Palm Beach
ACKNOWLEDGED BEFORE ME THIS 15 DAY OF November
BY Joseph Holston
HAS
IS
2017
TO ME i , OR
AS IDENTIFICATION.
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FOR OFFICE SE 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 7/21/2014