HomeMy WebLinkAboutPERMIT RENEWAL REQUESTOct 25 2818 10:47:51 Via : " -> 7724626443 Plat`' 'g & Deuelopme Page BB2 gioz
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER-- 1802,0100
FILM,D]ING AND CODE REGULATIONS DIVISION
2300 VIRGIMA AVE
FORT.PI:ERCE, SE 34982 RFC�VFo
(772) 4'62-7553 Fax (772) 462-1578
peM5 71 10I8
PERMIT RENEWAL REQUEST St <17
tle0 c u�7'enr
ADDRUS: PL TUMpike Service PIazO (MIL 144) Part St. Lucie. 34986
I, Jonathan Anderson am requesting that the above permit be renewed, i
understated drat I rtsust scheeMe and pass all required inspections for the pennant to be filmed. Further, .I
unden tand that this is a'( ONE i IiVi l RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
7ustitieation We failed to calendar -the inspection date correctly.
OWN . 8LDR OR CONTRACTOR SIGNATURE DATE
Jonathan P. Anderson
STATE OF FLORWA
AC'KNO1WLEDGEY713L"VOR�E ME TMS 2,0- DAY OF t�)�-a hc. r 20 ( K
$Y --.,)[her;JnAy�..µfir,O�p,�S,'��__..... WIiO iS PERSONALLY KNOWN TO Mii..._,"' _ OR
H S PROVIDED AS IDENTIFICATION.
STATE OFF ORTDA, County of•
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. ��.e��- � � - ; , o:. NataryPu6lit-StateolFtmida
_ VIF I MCamm�ssicn#00092080
SIGNATURE OFNOT SFAL `•,0,�• - YtmnmEwpiresApr5,7021
Aonctd@mSttWtmyi Wlufasm
FOR OFFICE USL ONLY:
Number of Open Inspections: _ SCANNED
Tout lagwxImnc: SY
(Divide.openbytotal.toget %ofcape.ninspecPkinsl St. Lucre Cou
nty
unty
ociginao,iX mat fee: x %a opera S _ Renewal (cc
Example: 115 divided by 23=.6,5(%)j 5175(pertn t Cee) x ,65=^�t 13.75 Irene ran f'ee)
Revised 72tr2014