HomeMy WebLinkAboutPERMIT RENEWALPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578 RECEIVED
UG 0 01
PERM[IT RENEWAL REQUEST AUG 0 2 2018
SUANNED
BY ST. Wde Gounty, wmirtingo
St. LUCle uritv,-
PERMITNUMBER: SL4,174- 0393 ADDRESS . IjWb S P2 �j A 3 � "5-
1, RC)6(�- ' am requesting that the above permit be renewed. I
understand that I niust 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 I j./ 14. 1 Tj a fo ro R 1!�V6 t x166-ilt 1 fj.4 L-
OWNER/BLDR OR CONTRACTOR
K4& f�264
Print Name
h 0 Ile
DATE
STATE OF FL
COUNTY OF = & r DAY OF
ACKNOWLEDGED BEFORE ME TIES
20 JY
BY �()6(a
W110 14E LY�KNOWN
�.OR
HAS PROVIDED
7� T County of
SIGNATURF OF��-
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
AS IDENTIFICATION.
L MEGHAN A CLAIR
07
W COMMISSION 0 F 9 2U
E p 'ugu't ()5, 019
- 40 MX IRES A 2
- '%r-
WCOMM
SEAL ISSION 0 FF907264
EXPIRES August 05,2019
00113 1 FWnd&WjySe..
Example: [15 divided by 23=.65(%)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/21t2014