HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENTSERVICES DEPARTMENT
BURRING AND CODE REGULATIONS DIVISION
2300 VIRGMAVE
— FORT PIERCE, FL34982
(772)462-1553 FaxCM)467r1578 RECEIVED
SCANNED PERMITRENEWALREQUEST NOV 112019
St. Luce County ST. Lucie County, Permitting
PERMIT NUMBER: II D — U 233ADDRESS: 1 ID1) 0 S. O 0� M
Gr am requesting that the above permit be renewed. I
understand th t 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 shalt expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification !)l D NtTr REALIZE IT WA5 Nb7 Gt.0>`EP DtA
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ONTRACTOR SIGNATURE(L)ALig
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STATE OF FLORIDA
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS DAY OF
BY WHO IS PERSONALLY KNOWN TOME.OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA, County of
SIGNATURE OF NOTARY SFAL
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(permitfee) x.65=$113.75(renewal fce)
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