HomeMy WebLinkAboutPERMIT RENEWAL REQUESTW FT Ne+o
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST.
PERMIT NUMBER: SLC1902-0154 ADDRESS: 8701 ORANGE AVE
0
I, Stanley Maclin . am requesting that the above permit be 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 MasTec Network would like to request an extension for the above referenced
permit due to a delay in receiving back ordered equipment to complete the proposed work
Stanley Maclin
OWNERBLDR OR CONTRACTOR SIGNATURE
Print Name
11/7/19
DATE
SCANNED
BY
St. Lucie County
STATE OF FLORIDA
COUNTY OF Palm Beach I� // II
ACKNOWLEDGED BEFORE ME THIS 4 DAY OF NOV Es t. L A-/ ,20 (p
t
BY gontkksAae.L WHO IS. PERSONALLYKNOWN'TOME. k ,OR
HAS PROVIDED
AS IDENTIFICATION.
STATE OF FLORIDA, C unty of &(Wt �RaA
YANEf 101RIGil"
�? ' \•��s: No Public -State of Florida
�Q a Commission R GG 32598o
SIGNATURE OF NO' SEAL ... toF tid:' My Comm. Expires Apr 21,..2023
Bonded through National Notary Assn,
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(0/o)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014