HomeMy WebLinkAboutPERMIT RENEWAL REQUEST06-19—'18 13:31 FROM— T-367 P0001/0002 F-238
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
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®' BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fa (712)462-1578
SCANNED
800642 PERMIT RENEWAL REQUE�` BY
Sprint DO Macro Jt. Lucie County
N972XCO13
PERMIT NUMBER: 1710-0140 C ADDRESS: 168000keechobee Road
I Richard Lee Cullum , am reAuesting 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 need more time for construction
Let Lb_ --- b/ qM
O WNER BLDR OR CONTRACTOR SIONATURE T
Richard Lee Cullum
Print Name
STATE OF FLORIDA
COUNTY OF Palm Beach
ACKNOWLEDGED BEFORE NIB THIS 19 DAY OF June .20 1$
By Richard Lee Cullum WHO IS PERSONALLY KNOWN TOME X OR
FIRS PROVIDED
STATTE9L ,Countyof Palm Beach
GNA OFNOTARY
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fcc: x % open = $ Renewal fee
AS IDENTIFICATION.
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Example: [15 divided by23=.65(%)l $175(permit fee) x.65=$113.75 (renewal fee)
Revised =1120l4
JUN 2 0 2018
Permitting Department
St. Lucie County, FL