HomeMy WebLinkAboutPERMIT RENEWAL REQUESTf-PLANNINGAND-DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2M VIRGINIA AVZ
— - FORTPIERMYL34"2
- - - - - - - (772) 462-1553 Fax.(772) 462-1578:
SCANNED R7202rO
PERMIT RENEWAL REQ ST
St, Lticg County M
ST. Luci
PERMITNUMBER: 1908-0313 ADDRESS: 3929 Shoreside Drive
r, Alan Tarpell am requesting that the above permitbe renewed. I
understand that I must schedule and pass all required inspections. for the permit to be fmaled. Further, I.
understand that this is a ONE TME RENEWAL and the pennitshall expire should -I not -receive a•
,passing inspection,duting any six month period during the. renewal period.
Justification Fence permit for Pool'
Zv 2-v
OWNER/BLDRORC MORSIGNATURE DATE
1Y : tl .
Print Name
STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE M&THIS DAY OF � u 4 20
BY .V�-C.�� WHO Is PERSONALLY.KNOWN TO ME: . OR.
it/:KUM=
AS IDENTIFICATION.
Pubft State of Florida
FOROFFICE 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
Exampte5 [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014