HomeMy WebLinkAboutPERMIT RENEWAL REQUESTFCOUNTY
F L O
R I D A
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
SCANNED
BY
St. Lucie County
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 F" (772) 462-1578 "EAUG
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PERMIT RENEWAL REQUEST19ermitting
PERMIT NUMBER: SLC 1712-0478 ADDRESS: 3301 Orange Ave
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 periodduring the renewal period.
Justification There was a delay in receiving back ordered equipment to complete the proposed work.
,� �r
OWNER/BLDR OR CONTRACTOR•SIGNATURE
maclin
Print Name .
STATE OF FLORIDA
COUNTY OF
yal/%
DATE
ACKNOWLEDGED BEFORE ME THIS DAY OF S4 20__Lq_
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BY ! A c,,1.Q h_
WHO IS PERSONALLY KNOWN TOME , OR
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HAS PROVIDED
AS IDENTIFICATION.
STATE OF FLORIDA, County of
YANET RODRIGUEZ.
Notary Public
SIGNATURE. OFNOT
- SEAL
- State or Florida
'�'� p Commission # GG 325980
My Comm. Expires Apr 21. 2023
_
Bonded through Nations! NdtarY Assr,
FOR OFFICE USE ONLY:
Number of Open Inspections: —
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage: �p
f —Original permit fee: - x % open = $ Renewal fee
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014