HomeMy WebLinkAboutPERMIT RENEWAL REQUEST- - PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
- • -j BUILDING AND CODE RE GULATIONS'DIVISION
2300 VIRGINUAVE
FORT PIERCE, FL 34982 SCANNED
- (772) 462-I553 Fax 072).462-1578 BY
SCANNED St. Lucie County
BY PERMIT RENEWAL REQUEST
St. Lucie County l�l
PERMITNUMBER: /-7OS-OG'.5 ADDRESS: 9-F0ci \4.,mywv4 GT gLbG 3
the above Vpermi(be.renewed. I
or the permit fo be'finaled. Further, I
shall eitpire should I not receive a
I period.
Justification
Allj
DATE
PTr Ill./ /&A1
Print Name
K�.
STATE OF,
F =Y1C-j0—r1a-
COUNTYOF M0L/r10YI
ACIMOWLEDGED BEFORE ME THIS- 13-0'. DAYOFp'fl` _ .20AB
BY %TW4 ' W i U i 0.fYtS WHO IS PERSONALLY KNOWN TO ME : OR
HAS PROVIDED
?radian
sIrA'TEoF ,4,.countyof M
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 _.[S5 dividedby23=.65(%)] $175(pemrit fee) x.65=$113.75.(renewal'+fee) _ _ _ M _
RcVM72trzm4 APR 13 2018
Permitting Departme�ltt
St. Lucie County, FL