HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
' BUILDING AND CODE REGULATIONS DIVIS1L
2300 VIRGINIA AVE RECEIVED
--'----'---- -- FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578 OCT 19 2017
OUANNtU PERMITTING
BY PERMIT RENEWAL REQUEST St. Lucie County, FL
St. Lucie) Co
unty q p T
PEpRMI�TNUMBERbdd / ADDRESS: I(FOO s. 0ccw..� Or. Vcnlz,.� (3" Fc 3Y9t-7
I, l.�/� 1 UCw' t l�n•���'. 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
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DATE
L, ,lfa�1,���t,1s��s
Print Name
STATE OF FLO D
COUNTY OF nn
ACKNOWLEDGED ORE ME TIRS _I DAY OF 20j!j
B_
BY�j I�t MIS nNIS WHO IS PERSONALLY KNOWN TO ME ,OR
HAS PROVIDED t' L_ /b• AS IDENTIFICATION.
Number of Open Inspections:
Total Inspections: -
(Divide open by total to get % of open inspections) .. - .
Percentage:
Original permit fee: x % open = $ �7, g Renewal fee _
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$I 13.75 (renewal fee)
Revised 7/212014