HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES I)EA'ARTMENT
BUILDING AN.I) ('O[)E REL:OLA'FIC)N$')'VISION RECENED
2300 t'IRCJti61.t1'E
FORT I'lliRt'F, FL 3419112
(77ZI 462-1."3 Fax (772) 462-1578 FEB 211010
SCANNED Permitting 9sPortmcnt
BY PE%111T RENEWAL REQUEST ft Lucie County
St. Lucie COB*
PIiRMIT\G?tRL'R:.jj(?(o---�? _1 ADDRESS:.__j- 6—Q -- .�—'.---
I, C I c /Y_ lqw-14/)_0 0"_ . an) requesting that the above permit be renewed. I
understand thai ' must schedule and pass all required inspections for the permit to be ffnaled. Further, I
understand that this is a ONE TIME RENEWAL. and the perm t shall expire should I not receive a
passing inspection during any six month period during the renewal period. / p
Justification 123010 en L.J: 3 it/u� C t'-VP f''Pa �. ! Eu-s-ecr
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SIGVATIiRE DATE T
Lr&c, s'zc'ui C-4j,
Print Name r
STATE OF FLO W IM .{
CCIVNTY OF F`l c.et D /d
Y/
ACxNUR'LF.UGI'.D BEFORE. THIS a2. C DAY OF-,�( '?6 _.20 -Gs •.
HY i,� sC 6P 0 -WIJO tS PE\RtioALLY t:NO%VN TONE
HASPRDviDED lit X )``-7 ZJLO L( Z 0 _ ASIDENTIFICATION.
STA OF LOWDA. C'ounn of
ig^,. SNERRYTOOMEY
n� „ Notary Public. state of Florida
tirAL :� a' Commission B GO 22A708
tiiG L �,7 (,Ij RY /��j� ?or v My COMM. Expires Jun], 2022
(� "� 7 Bonded through National Notary Assn
FOR OFFICE (1S£ ONLY
Number of Open Inspections:
Total Inspections; _
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x%open- SRenewal fee
Example: (15 divided by 23=.65(%)j S175(permit fee) x .65=S113.75 (renewal fee)
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