HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND D//EVELOPMENT SERVICES DEPARTMENT
S o"" BUILDING AND CODE REGULATIONS DIVISION (�
. ■ � 2300 VIRGINIA AVE
FORT PIERCE, FL 34982 RECEI
(772) 462-1553 Fax (772) 462-1578
SCANNED FEB 0 5 2019
BY PERMIT RENEWAL REQUEST ST: Lucie County, permitting
St. Lucie CountV
PERMIT NUMBER: 1711-0508 ADDRESS: 5690 ENVIRONMENTAL DRIVE
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 DELAY IN THE DELIVERY OF EQUIPMENT FROM AT&T RESULTED IN A
CONSTRUCTION DELAY.
OWNE"LDR RCONTRACTORSIGNATURE DATE
Slit✓/� /fifc�.�
Print Name
STATE OF FLO DA ,/� j
COUNTY OF 6(I m 13 PC'tC r )
ACKNOWLEDGED BEFORE ME THIS > DAY OF JQ r yQ y , zo�
BY WHO IS PERSONALLY KNOWN TOME V OR
HAS PROVIDED
STATF,OFFLORIDA, County
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
AS IDENTIFICATION.
Notary Pubk State of Florida
¢ Theresa Ann Fenusi
VMy commis9lon GG 240684
Expires 07=2022
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014