HomeMy WebLinkAboutPERMIT RENEWAL REQUEST_ PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
Lmsj 2300 VIRGINIA AVE
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FORT PIERCE, FL34982
(772)462-1553 Faz(7R)462-1578 RECEIVED
SCANNED PERMIT RENEWAL REQUEST NOV 0 2 2018
BY ST. Lucie county, Permitting
St. Lucie County
PERMITNUM�2� Fick
1IO 1�dJro ADDRESS: 'n46 S, C�CCU rJC, U�\c �vJ� Jl
I, , 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. TUVIE RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
Print Name
STATE OF FLQjtIDC�` \ C
COUNTY O
ACKNOWLEDGEDBEFORE NETHIS a
AM
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DATE r I
DAY OF,) CA
'. 20-�--
BY iC\C. S0\6y-16`t\ WHO IS PERSONALLY KNOWN TO ME .OR
HAS PROVIDED D t- AS IDENTIFICATION.
TATEOFtyo�
SIGNATURE OF NOTARW
FOR OFFICE USE ONLY:
DEANNAMARIE GIVENS:
MY COMMISSION 0 GO 022d23
EXPIRES December 16, 2020
Bwded Thu Nola MUG Undenmtem
Number of Open Inspections: a V
Total Inspections: \13
(Divide open by total to get % of open inspections)
Percentage: .
Original permit fee: /o,open = $ Renewal fee
Example: (15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014