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Home My WebLink AboutPERMIT 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: / ! 0 4P— v &ISADDRESS: '-? tW ' 6't (/O p) ` I, q;61 4'1c% �7�o P�c7�7© �d , 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 OWNER/BLDR OR Print Name STATE OF FLORIDA COUNTY OF �. 4e- ACKNOWLEDGED BEFORE ME THIS DAY OF / Y 20_ BY a WA -0,9/ - (groeh ""O IS PERSONALLY KNOWN TOME OR HAS PROVIDED a AS IDENTIFICATION. A 1 STATE OF FI ORIDA, County of SIGNATME OF NOT. SEAL FOR OFFICE USE ONLY: A Number of Open Inspections: B �� . J ---, I q�• 7 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