HomeMy WebLinkAboutPERMIT RENEWAL REQUESTv'aaaaaaaaaaaaaa* PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
2300 VIRGROA AVE.
FORT PIERCE, M 34M
"7ZM2-155' JUHNNED
e
County
PERMIT RENEWAL REQUEST 't Luc
ADDRESS: pC .( �x__ Lf . 7. 1 PERMITNU51BER St--1� l �O� �v�
41 J r .L_
d. I understand that I must schedule and pass all
to be finaleda Further, I understand that this is
shall expire should I not receive a passing inspect
the renewal period.
Justification
STATE OF FLORIDA
COUNTY OF &DLt.A2.1
the
L and the
iperiod
ACK/N�OWLEDGEDBEFORE ME THIS 0 DAY OF . 200=
BY WHO IS PERSONALLY KNOWN TOME _ // OR
HAS PROVIDED
IDENTIFICATION.
STATE OF F/LLORIDA,County of
SIGNATURE OF iARY - Notary PuSk-Stneafflarwa
FOR OFFICE USE ONLY: ; ,.f MYa�aME)Pwaa AF 9, 2021
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = _ $ Renewal fee
Example: ]15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revbed 6IM014