HomeMy WebLinkAboutPERMIT RENEWAL REQUESTApr 15 19 09:51 a Flamingo Signs 772-29()-7768
PLANNINGAND DEVELOPMENT SERVICES DEPARTMENT
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BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34992
(7-72) 462-1553 Fax (772) 4624578
PERMIT RENEWAL REQUEST
PERMrrMJMBER'. qg �1809--Q20� ADDRESS: 9650 S. Ocean Or Jensen Beach Fl
1. Flamingo Signs LLC arm requesting that the above permit be renewed. I
understand that I must schedule and pass aU required inspections for the permit to be finaled. Furtherl
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six mouth period during the renewal period.
b,,,;.F,m-f,s,--etietWTwj_postpone job, once completed we failed Inspection and then
permit expired I�We corrZ�qtions were
4/15/19
DATE
Robert D Gralak
Print Name
STATE OF FLORIDA
COUNTY OF fu At-1 I ti
ACKNOWLEDGED BEFORE METHIS 16- DAY OF 1) fA 1 t- 2q.1'7 _
BY _A 0,11�'X T /r-/L h- I- WHO IS PERSONALLY KNOWN TO ME t-� OP
HAS PROVIDED PA I LIZ'A 'S' I C e Ae-�e AS IDENTIFICATION.
STATEOFFLO D Cowaty.r—
o� K,,M pbk, State at MOO
Robert bi Rim
my c,mmkmlon GG 072776
011 Epirea OV034021
SIGNATURE OF NOTARY REED
FOR OMCE USE ONLY:
Numlacrof0penlaspections:_
Total Inspections: -
(Divide open by total to get % of open inspections)
percentage:
Original permit fi:e: _ x % open Rcnekval fee
Example: [l5divjdcdby23--.65(%)] S175(permitf�) x.65=$113.75 (renewal fee)
Rmsed 7121/2014
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