HomeMy WebLinkAboutPERMIT RENEWAL REQUESTFrom: 10/08/2019 15:05 It790 P.002/002
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
•
.ANNED
BY
St. LOCI@ County
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGL\9A AVE
F012T PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
PERMIT RENEWAL REQUEST
PERMrrNUMBER: SLC1712-0304 ADDRESS: 8701 ORANGE AVE
1 STANLEY MACKLIN -,am requesting that the above permit be renewed. I
understand that 1 must schedule and pass all required inspections for the permit to be finaled. Further,
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 BACKORDERED PARTS
STANLEY MACLIN
?rint Name
STATE OF FLORIDA
COUNTY OF PAWOUkCH
ACKNOWLEDGED BEFORE ME THIS 8
BY STANLEY MACKLIN
HAS PROVIDED
10/8/19
DATE
DAY 017 OCTOBER
2019
WHO IS PERSONALLY KNOWN TO ME X , OR
/STATE 01: FLORIDA, County of PALM BEACH
SIGNATURE OF NOTARY
MICHELLE SCHEIN
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.
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Example: [15 divided by 23=.65(0/.)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/2112014
WFTPIERCE3C
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(172) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
i`712- D3u`f
PERMIT NUMBER: SLC 2017-6304 ADDRESS: 8701 Orange Avenue
I, Stanley Maclin 0 , 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 Solutions is requesting a renewal in order to complete the work and close the
permit out as there were delays in receiving equipment
3/12/19
OWNS L R CONTRACTOR SIGNATURE DATE
Stanley Maclin
Print Name
STATE OF FLORID �e
COUNTY OF 19 j�
ACKNOWLEDGED BEFORE ME THIS ' � DAY OF t ' t CI ( h , 20
BY O IS PERSONALLY KNO _ ,,OR
HAS PROVIDED AS IDENTIFICATION.
County of
SIGNATURE OF NOTARY .1a'r n Noggytr[,utHc State of Florida
Theresa Ann Ferrusi
My Commission Go 240684
mw° Expires 07/2212022
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: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014