HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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J g Tw BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
SCANNED RI�n
BY PERMIT RENEWAL REQUEST OR 13 ?plp
St. Lucie County ?ermlttlnso
St. Lucle coin ++eat
county
PERMITNUMBER: 1707-0341 ADDRESS: 4911,4917,4913,4915
I The Roof authority, Inc. 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 Permit expired
OR CONTRACTOR SIGNATURE
A. Long
-%p/z z//, K
UAL
STATE OF FLOJDt
COUNTY OF . ucie
ACKNOWLEDGED BEFORE ME THIS i ` DAY OF ,"I D h I .20AS—
BY Christopher A. Long
HAS PROVIDED
STATE OF FLORIDA, County of St* LUCie
Ivi,.�,►JS�.�Ca.-
SIGNATURE OF NOTARY
FOR OFFICE USE ONLY:
WHO IS PERSONALLY KNOWN TO ME X . OR
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
AS IDENTIFICATION.
�j Mr4y. Timothy W. Sutton
: NOTARY PUBLIC
ESTATE OF FLORIDA
W = Comm# GG185982
'RME As"b Expires 3/20/2022
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014