HomeMy WebLinkAboutPERMIT RENEWALPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGE41A AVE
FORT PIERCE, FL34982
(772)462-1553 Fax (772) 462-1 8 RECEIVED
SCANNED PERAHTRENFWALREQ STAUG021ZO18
BY ST. LucleCounty, Permit
St. Lucie CountV
PERMIT NUMBER: -SLC 1740,5-- ADDRES§: 0054nQf- :1'1'3 V95---1
1, R012<e4 k' , 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, 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 W/rjrJ6 r9le e LIV&4,69 #Cdo Z
-7 /3 1) Zlf
DATE
Print Name
STATE OF FLCPA
COUNTY OF a 6 &'�' 0,
ACKNOWLEDGED BEFORE ME TBIS
20-1—
Y�' DAY
BY K6VYA '�*C'4L qAL
_��LYKNOWN ME.OR
_!N
HAS PROVIDED AS IDENTIFICATION.
County of
SIGNATURE OF NOT
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
MEGHAN A CLAIR
Z MY COMMISSION# FF907264
SFj EXPIRES August 06. 2019
,,d.Nm,ysmk M,
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/21/2014