HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIIYIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578.7
PERNUT RENEWAL REQUEST AUG 7 3 2011
PERM-THdG
St. Lucie county, FL
PERMIT NUMBER: t?Q /:i_T,s: FQ ADDRESS: I i 9 U M O LLE'(C
I, SSE oz /A OLS e-f fi ifr— 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.
Justification A . f1@ JI.S10 of To -rtJa- pool. DtciS , r-40SeD oo R
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DATE
SP;Pkrh s! Z' 6MLSd-yN114
Print Name SCANNED
BY
St. LUCie County
STATE OF FLORIDA
COUNTY OF 9-1_ t 1JC.1 P
ACKNOWLEDGED BEFORE ME THIS QQ DAY OF A V C t 7ST , 20�_
BY lgk k i! 1 -eWHO IS PERSONALLY KNOWN TOME --X . OR
HAS PROVIDED
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
AS IDENTIFICATION.
7' Notary PubOe to e1 FIWO
Danike King
SE +� p` My Commtseioe FF 97122e
'4pgd' Expltey 1027/2019 VWVVJ
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7=014