HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENTSERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGE41A AVE
FORT PIERCE, FL34982
(772) 462-1553 Fax (7U) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: ` / —0 � 4DRES9: *W ro f A & J, 64dtv4 Alin G!�X
1, 4d)K &i UI V1 , am requesting that the above permit be renewed. I
understand that I ust 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 SbAN ED
r0WNERTIL•DR OR
/-6,4(_ 9eo rJin
w$iint,Nsmie
St. Lucie County
((/�q,/Iz
{*DATES
tippr',>u"�,; AUDREY B. HUMPHREY ,
t, ��`�: MY COMMISSIGNSGG 300817
�,po EXPIRES: March 6, 2023
_�'-'�rv°•' BondedThmNotary Public Underndters
STATE OF FLORIDA
COUNTY OF /
ACKNOWLEDGED BEFORE ME THIS DAY OF
BYm1�1< �'�UJ DII Od IS PERSONALLY KNOWN TOME.OR
RASPROVIDED, IA • AS IDENTIFICATION.
SE&L
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(0/o)) $175(permit fee) x .65=$113.75 (renewal
Revised 7/21)2014
NOV 18 2019
Permitting Department
St. Lucie County, FL