HomeMy WebLinkAboutPERMIT RENEWAL REQUESTFrom: i 05/0912019 12:30 0755 P.002/005
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
o BUILDING AND CODE REGULATIONS DIVISION
• - Y� 2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772)462-1578
SCANNED
BY PERMIT RENEWAL REQUEST
Lucie County RECEIVED
PERMIT NUMBER: SLC 1808-0006 ADDRESS: 3100 N Al PROD MAY 10 2019
I STANLEY MACLIN am requesting that the above permite 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 I WOULD LIKE TO REQUEST AN EXTENSION FOR THE PERMTI DUE TO A DELAY IN
RECEVING BACK ORDERED EQUIPMENT TO COMPLETE THE PROPOSED WORK.
05/7/19
OWN DR OR CONTRACTOR SIGNATURE DATE
STANLEY MACLIN
Print Name
STATE OF FLORIDA
COUNTY OF PA BEA
ACKNOWLEDGED BEFORE ME THIS 7 DAY OF MAY
2019
...... _MACI<.1N_._._........--------...W1jOIS-PERSONALLY-KNOWN TOME-x........_...---OR..,...
14AS PROVIDED
STATE OF FLORIDA, County of PALM BEACH
AS IDENTIFICATION.
SIGNATURE OF NOTARY
EV=�'YCCHELILE SCHEINS':Jw'�e 08�6G6B0
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
Example: (15 divided by 23=.65(%)] $175(permit fee) x .65=$I 13.75 (renewal fee)
Revised 721/2014