HomeMy WebLinkAboutPERMIT RENEWAL REQUESTI,
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
OUNTY • 2300 VIRGINIA AVE RECEIVER
������� - FORT PIERCE, FL 34982
BY
M (772) 462-1553 Fax (772) 462-1578 Jul �, Zo�s
if
3t. Laud( Co11 ntv permitting Department
PERMIT RENEWAL REQUEST st; Lucie county
7,�
RMIT NUMBER: 1808-0049 ADDRESS: 681 Rio Vista Dr. Fort Pierce, FL 34952
anielle Ryckman , am requesting that the above permit be renewed.. I
erstand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
erstand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
ling inspection during any six month period during the renewal period..
ification This was somehow overlooked with our previous employee and never was called in for inspection
OR CONTRACTOR SlI NATURE
7/1/19
DATE
ilnid Ryckman
t Name
1TE OF FLORI `
LINTY OF C
BEEDRE ME THIS
DAY OF 20'
KNOWLEDGED
WHO IS PERSONALLY KNOWN TO ME , OR
S PROVIDED
AS IDENTIFICATION.
ACE OF FLO , Co ty of
E:,.
DAVID ALAN JOHNSON
J ATU OF NOT SEAL State of Florida -Notary Public
Commission 1t GG 172248
My Commission.Expires
January 03, 2022
)R OFFICE USE ONLY:
ember of Open Inspections:
ital Inspections:
ivide open by total to get % of open inspections)
rcentage:
iginal permit fee: x % open = $ Renewal fee
.ample: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
vised 7/21/2014