HomeMy WebLinkAboutPERMIT RENEWAL REQUEST'-Jo-berxev�
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
SCANNED PERMIT RENEWAL REQUEST
BY
St. Lucie County
PERMIT NUMBER: SLC 1710-0444 ADDRESS: 10680 S Ocean Dr Project
I Stanley Maclin , 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 MasTec Network would like to request an extension for the above referenced
permit due Lo a delay in receiving back ordered equipmeni. LO complete the p osed work
OWNER/BLD _ CONTRACTOR SIGNATURE
Stanley Maclin
Print Name
11/7/19
DATE
STATE OF FLORIDA
COUNTY OF Palm Beach aaII
ACKNOWLEDGED BEFORE MnfETHIS —� DAYOF 100V&iA&'- .20�
BY �-(s„JA:A M 4e.L WHO IS PERSONALLY KNOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA, County of 001L14 l' ka ,.
YANEF RODRIGUEZ
^.; Notary public -State of Florida
SIGNATURE OF NOTS `�'? , o*eY My Conim.sEapires apr 21, 2023
Bonded through National Notary Assn.
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: 115 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/212014