HomeMy WebLinkAboutPERMIT RENEWAL REQUESTI
PLA1vNING AND DEVELOPMENT SER.. 'ES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
Permitting
nrie Count
PERMIT NUMBER: ADDRESS: 2651 Minute Maid Road, Ft. Pierce, FL 34945
I, H-n=gd 7 Pr-0yjP f-e.r0 , am requesting that the above permit be renewed. I
understand that 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 construction is not yet complete on this project.
CONTRACTOR SIGNATURE
Print Name
SCANNED
BY -
St. Lucie County
STATE OF FLO P1 r) -F ��
COUNTY OF F��(( y�� ,n
ACK OWyL�E�DGED BEFORE ME THIS DAY OF / I azxl .y , 20�
BYI r 1 CM 4M �/I �OIS PERSONALLY KNOWN TOME V—, OR
HAS PROVIDED
STATE OF FLORIDA, County -of
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 = $ _
AS IDENTIFICATION.
—•a"nr'a", NICOLE GRANT
o Notary Public •State of Florida
�: •; Commission # FF 181486
%.
My Comm. Expires Mar 31, 2018
......`•' Bondedthrough National Notary Assn.
m
Renewal fee
Example: [15 divided by 23=.65(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014