HomeMy WebLinkAboutPERMIT RENEWAL REQUESTr�
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AYE
PORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST SC BY EV
St. Lucie Cnllnt�
PEIL NUMBER: %() O �Z1� ADDRESS:_3n2IFR 5.1 r111R()retr e2 1�,'tdQ z
1' am requesting that the above permit be renewed. I
un erstand that 1 must schedule and pass all required inspections for the permit to be finaled. Further.1
understand that this is a ONE TIME RENEWAL and the permit shall expire should 1 not receive a
passing inspection during any stx month period during the renewal period.
Justification
l 0/A'E- CAA-C terra
STATE OF r ^^^T,
COUNTY or._ Q..tevJ "N4tA2rt
ACKNTOOWLEDGED]BE/FFOOREMETIBS 30�`DAYOF } � '0 (fi
BY ( \' Ca W110ISPERSONALLYKNOWNToME
.OR
HAS PROVIDED AIL, ot- �'3'j22
y , .1, dA&dl)JWIFICATIOD
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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 = S Renewal fee
K
NO j Frio 0
9 \A 9 1C
Example: [15 divided by 23=.65(%)] S175(permit fee) x .65=$113.75 (renewal fee)
Revised 72I2014
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