HomeMy WebLinkAboutPERMIT RENEWAL REQUESTC-
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGLIHA AVE
FORT PIERCE, FL34982
(772) 462-1553 Fax (772) 462-1578 — RECEIVED
I
PERMIT RENEWALREQUEST HT T 16 2018
I
Lucie County, permitting
PERMIT NUMBER: nL03-0 m LDRESS: /O DCW bey
I, 94c— r/ , am requesting that the above permit be renewed. /I
understand that Must schedule and pass all required inspections for lite 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
SCANNED
BY
St- Luce Countv
STATE OF FLORIDA
COUNTYOF
ACKNOWLEDGED BEFORE UETHIS �G DAY OF d 20A,
BY �i.�'1.e'CCQh WHO IS PERSONALLY KNOWN To ME ,OR
HAS PROVIDED f 1_ O L— AS IDENTIFICATION.
STATE OF FLORIDA, Countyof `�"t'. t V �• C — - - -
v DEANNA MARIE GIV—ENS
\ ?w; •+. 61YCOMMISSION#GG022023
SIGNATURE OF NOT - MW&S: December 16, 2020
'RoZi g°� BondedThru Notary p,br, Unde�wrflers
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
Example: [I5 divided by 23=.65(%)l $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014