HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
• 2300 VIRGINLI A,VE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
REC IVED
PERMIT RENEWAL REQUEST
i SEP 10 2019
ST. Lucie Coulity, Permitting
PERMITNUIvBPR: 1901-0160 ADDRESS: 314 Essex Dr
1, — ✓an�9 �%•Oa�a+ am requesting that the above permit be renewed.
understand that I m st schedule and pass all required inspections for the permit to be finaled. Fukher,l
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receiv' a
passing inspection during any six month period during the renewal period. a SCANNED
Justification - BY
t. Lucie County
iq
OW,NEER/T3 Off} CONTRACTOR SIGNATURE DATE
Print Name
STATE OF FLORID
COUNTY OF
ACKNOWLEDGED BEFORE
�iv,I�E��I lII�.$� DAY OF � 20 L
BY MQS r�85:& WHO IS PERSONALLY KNOWN TO ME OR
�—
' HAS PROVIDER AS II1ENrIFICATION.
ST OULORIDA, County of
•4y.Yo `.. BRn1ANYt. HUBER
F 1 •: Notary Public - 5 ate of Plorlda
SIGNAZTJF:E OF NSEAL
':'e0 t'.� Commission PGG 325682
r Fb'P My Comm. E.Pit May 14. 2023
Banded through Natiof at Notary Assn.
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)
RMl C17OV2014