HomeMy WebLinkAboutPERMIT RENEWAL REQUESTCANNED
BY
fit. !Lucie Cou"V
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGINIA AVE.
FORT PIERCE, FL 34982
(772)462-1553
PERMIT RENEWAL REQUEST
PERMIT NUMBER: I'y I ' 0 I U
I, III Q"4 AM REQUESTING THAT THE ABOVE PERMIT IS
WED FOR 18 MONTHS. I UNDERSTAND THAT I MUST SCHEDULE AND PASS ALL
REQUIRED INSPECTIONS FOR THE PERMIT TO BE FINALED. FURTHER, I UNDERSTAND THAT
T IS A ONE TIME RENEWAL AND THE PERMIT SHALL EXPIRE SHOULD I NOT RECEIVE A
P Q SING INSPECTION DURING ANY SIX MONTHS PERIOD DURING THE RENEWAL PERIOD.
� 3`f
ERBLDR OR CONTRA{'TO SIGNATURE DATE
ST '� E OF FLORIDA, County of Q 4.
AC OWLEDGED BEFORE ME THIS DAY OF , 20—a
1
BY�3eQ�A�WHOIS ERSONALL OWN, O ME , OR
�I
HA 1 ROVIDED AS IDENTIFICATION.
S i E OF FLORID, County, o C SEAL
COMMISSION NUMBER
;oV Pi''•.
q ...
MGELA M. HUFF`
MY COMMISSION # EE OB3530
o °
Bonded
EXPIRES: April 12, 2015
Thru Notary Public Underwriters
FOR' FFICE USE ONLY:
RENEAL FEE: $ � -
I o
No. ofy;Open Inspections = Total No. of Inspections = (% of Open Inspections).
Permit Fee $ x Open Inspections (%) = $ (Renewal Fee).
[15 = 23 = .65(%)] $175.00(permit fee) x .65(%) = $113.75 (Renewal Fee)
REV 4/11/2011