HomeMy WebLinkAboutPERMIT RENEWAL REQUESTDecember 05, 2.019 0921 To:7724621578.NET2PH0HE.00.F Fax:7724621578
— — — — --PLANNING-AND-DEVELOPMENT-SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS D N
FORT PIERCEE,,FL 34982 RECEIVED
(772)462-1553 Fax (772) 462-1578
DEC 0 6 2019
PERMIT RENEWAL REQUEST ( ST. Lucie County, Permitting
r
PERMITNUMBER �j/�
' � � vtl!'� :I :ADDRESS: �J 0(0 Yi SL
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,!
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. (: 1 h 9
SCANNED
`DATE � � �. Luce County
STATE OF FL
O COUNTY OF " V✓LJy7
ACKN WLLE{DG,E'D'BEF.{O-I(jE M� � TJr Sn - DAY OF �' Y , 20
BY �'"'{''Y�-V�I; t-'6'ZJWY�. WHO IS PERSONALLY KNOWN TO ME V ,OR
HAS PROVIDED AS IDENTIFICATION.
Countyof 1" U1A,L 10 TRACEY W. MCGHEE
- e NOTARYPUBLIC
s STATE OFFLORIDA
U F NOTARY .: Conn* GG360070
s t e Expires 81102023
FOR OFFICE USE ONLY:
Number of Open Inspections: t 0.
Total Inspections: 2,5
(Divide open by tgt�1 to get % of open inspections)
Percentage: ;� `t 61 LL
Original permit fee: - ..: x % open = S 2 -�7JRenewal fee
Example: [15 divided by 23= 65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21n014