HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING'AND DEVEIAPMENT SERVICES=DEPARTMENT
BUIL:DI[NG^AND-CODE REGI MATIONS DMSION
2300_VIRGINIA AVE
-" - —'— ]FORT PIERCE7FL3498Z.
''----- --'-' -(772)44553; Falf -)d6�t578 RECEI\lrfa
- SCANNED
BY PERMIT RENEWAL:REQUEST MAY 0 8
St. Lucie County
Q�y / S-r. Lucle County, rermltting
PERIv1ITNUMHBR,� �,• D� {ff , ADDRESS, /P�-r///AZ:Gi ./✓� �C%Gl/' ('
per" ' atn requesting that the above permit,be renewed. I
understand; that I mug sched a and pass'all •equired"inspections: for ttie p^ettrut to be tinaledi: Further;,I.
understar_ .that this is a ONE TIME,RENEWAI and.thepermit shallezpire-,sbould I notrecetve a
passinginspechon during any six'month'period during the renewal period _ -;t All,
Justification '
Al
OWNFR/BG O ONTRACTORSIGNATURE DATE
STATEOF PORib ,
COUNIlL .�YFL
ACKNOWLEDGED BEFORE ME T is L I� _
DAY OF
BY _ WHO.IS PERSONALLY KNOWN i -.OR
HAS PROVIDED - - .�. _. AS IDENTIF1CATiON.
tuw. iinyccuvia.
(Divide open by tbtalto get "/o ofopeninspecuons).
Percentage'. -
Origmalpermiff4im x%a open $, Redewatfee
Example; [I5 divided,by;B=.6S&)] $l75(permit fee) x .65=$113.75 (gene)w[fee)
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