HomeMy WebLinkAboutPERMIT RENEWALPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 R AVE
FORT PIERCECE,, F FL 34982
(772) 462-1553 Fax (772) 462-1578
MAR 0 2 2020
PERMIT RENEWAL REQUEST
ST. Lucie County,
PERMIT NUMBER: 19 05 - 0685j ADDRESS: 78 6,'� �--c^-y Cove, n
I, avi c� /� . ) kers a>✓ , 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. SCANNED
Justification BY
St. Lucie County
Zed, A w
OWNER/BLDR OR CONTRACTOR SIGNATURE
J)c, cl_. A . N/ )k-e-Ys%--
Print Name
STATE OF FLORIDA
COUNTYOFS�,�-J \�
ACKNOWLEDGED BEFORE ME THIS a DAY OF i*"N a
�3,-,)-ZG
DATE
20aa
By P 4^I �. \' \\ tia s eat WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED Y-o —\- L- AS IDENTIFICATION.
STATE OF FLORIDA, County of
SIGNATURE OF NOTAW SEAL
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 fee)
Revised 7/212014