HomeMy WebLinkAboutPERMIT RENEWAL REQUESTPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772)462-1553 Fax (772) 462-1578
PERNIIT RENEWAL REQUEST
PERMIT NUMBER: 0-3 / O ADDRESS: / te O 0 J. ocm r, J)r- 7
I, 1 r E1'LC3J�ohll �� , 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.
SCANNED
BY
St. Lucie County
STATE OF FLORID
COUNTY OF y,
ACKNOWLEDGED BEFORE ME THIS '� & DAY OF C�Lr� , 20 to -
BYY ' /� C Die / l S'� Lt%%WHO IS PERSONALLY KNOWN TO ME OR
HAS PRnvTnF.T)
FOR OFFICE USE ONLY:
Number of Open Inspections: _ 1S Q D n " -
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
A u1TNMVTr.A�nXT
Example: [I5 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7212014