HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTME
BUILDING AND CODE REGULATIONS DI
VISION
2300 VIRGE41A AVE I �� .�
SCANNED FORT PIERCE, FL34982 C t b: i;-P,
(772) 462-1553 Fax (772) 462-1578
BY
Jum 0 2 2017
St. Lucie County
PER,.T RENEWAL REQUEST PERI ITfI,NG
St. Lucie County, FL
PERMIT NUMBER: I �On� O l ', l ADDRESS: 1 i 1 Q l J. OQR�(ne &fond
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I, I Tho mras v�In reYit�sting that the above permit be renewed. I
unc�erstand�l at 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.
S�I�ll17
SIGNATURE DATE
Il�omas S cayricy-
Print Name
STATE OF FLOLUDA
COUNTYOF l&`ac"
ACKNOWLEDGED BEFORE ME THIS n DAY OF � 20
BY 1'l OYYI Q S .� , Ca r-y i r. L. WHO IS PERSONAL KNOWN TO lVID ✓ OR
HAS PROVIDED
STATE OF FLORIDA, County of 'CU ] Yy'1PQC-�'�
SI A �FNOTJL��
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections) O
Percentage: QH
Original permit fee: x % open = $ _Renewal fee
AS IDENTIFICATION.
I
JACLYNN E. MCNEVIN
r ; Notary Public -State of Florida
Commission 6 FF980222
S =j
fi' My Comm. Expires Jul 30, 2020
M1;,q; „t.�Bonded through National Notary Assn.
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014
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