HomeMy WebLinkAboutPERMIT RENEWAL REQUEST`1 L
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT `
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578 RECEIVED
PERMIT RENEWAL REQUES F JAN 2 4 2019
Sf. Lucie County, Permitting
PERMIT NUMBER: 1806-0694 ADDRESS: 7703 Winter Garden Pkwy
I, Michael Flaxman , 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 Job not done, waiting on tank to be installed
SIGNATURE
Michael Flaxman
Print Name
1 /24/19
DATE
STATE OF FLORIDA
COUNTY OF St. dude
ACKNOWLEDGED BEFORE MET IS DAY O 20j
BYM I C 6 ) CA)(MuO IS PERSONALLY KNOWN TO , OR
HAS PROVIDED 157 AS IDENTIFICATION.
ST TE A o f • Lucie
,/ - I - m - - - ��l
`ipPV A BLACKSHEAR
�- State of Florida -Notary Public
My ComrR9
SIGNATURE OF NORY a Commissiona GG 237867
40on Expires
TA
July 12, 2022
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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 7/21/2014