HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772)462-1578 /QF
PERMIT RENEWAL REQUEST �909
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PERMIT NUMBER: `V — O Y✓ADDRESS: ZDCRO S 6CA2A'" —U/2' F'44
I, t- h, TO ?J/�J� am requesting that the above permit be renewed. I
understand that I Ost 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 /✓[%) I-- CSC
OWNERBLDRORCjd "RAI 'IGNATURE
�
Print Name
STATE OF FLO$g,Iip�A
COUNTY OF 7x
4 -
DATE
SCANNED
BY
St. Lucie County
ACKNOWLEDGED BEFORE ME THIS a'a DAY OF P C %% , 20n_
BY JZA �, .� O U h.1 In� WHO IS PERSONALLY KNOWN TO ME , OR
U
HAS PROVIDED T,L 1— AS IDENTIFICATION.
OF FLORIDA, County
OF
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
DEANNA MARIE GIVENS
EXPIRES: December 16,2020
AM Tbm Aletary Public UnderNdIers
Example: (15 divided by 23=.65(%)I $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014