HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
SCANNED
BY
St. Lucie Count1Y
PERMIT
I, � �'S �a yy✓1cS U �
understand that I must schedule
understand that this is a ONE TI
passing inspection during any six
Justification
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Print Name
STATE OF FLO
COUNTY OF I
BUILDING AND CODE REGULATIONS DIVISION
FORT PIERCE, FL 34982 RECEIVED
(772) 462-1553 Fax (772) 462-1578
NOV 2 9 2016
PERMIT RENEWAL REQUEST PERMITTING
St. Lucie County, FL
)DRESS: `360 nieo,r�
am requesting that the above permit be renewed. I
iuired inspections for the permit to be finaled. Further, I
AL and the permit shall expire should I not receive a
duringthe renewal period.
1 2!�) l 6
ATE
I tD
ACKNOWLEDG
D BEFORE ME THIS DAY OF 20
BY l'Vl •
WHO IS PERSONALLY KNOWN TO MEL, OR
HAS PROVIDED
AS IDENTIFICATION.
STATE OF FLO
C,=tj o
KAREN S. NIELSEN
Commission # FF 115637
SIGNATURE O
O
-��•: M f$,5lmmission Expires
June 12. 2018
FOR OFFICE USE ONLY:
Number of Open Inspections: _ O
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage: N `
Original permit fee: x % open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014