HomeMy WebLinkAboutPERMIT RENWEAL REQUEST11-17-14;12:27PM; # 9/ 9
PLANNING AND DEVEWPMENT 9E11vIC11-S DE11111
Building and Code Regulations Division
2300 VMGM AVF-
FORTPMRCB, FL 3"s2
(772) 462-159 Fex (M 462-7573
PERMIT' RMwAL REQUEST Cd�1
pERMITNVMSER: SLC• L'312- 0072- ADDRESS: MOO US 2 ?a -t St L.VCie
Alvaro C1co- am requesting that the above P=4t be renewed. I
uudersttutd that I must sc edule and ass all required tnspecttP for the permishou d I mot recoly a�Sr I
understand that this is a ONE RENEwAI.lrtd the t shall expire
Passing inspection during any six month period during the renewal period
Iustifcatton Conhr b 10v tx de o.1i' a � rrrti �"
C_�CSG.
OWNER/ WR Q$ CONTRACTOR SIGNATURE
A�.r�fl C IG
print Name
II �17�IU
D
SCANNED
BY
St. Lucie County
STATE OF R A
COUNTY OF OC y�
ACKNOWLEDOED BEFORE WE TMS I� DAY OF
BY a1 j-L Q3C7- WHO IS PERSONALLY KNOWNTOMB OR
FTAS PROVIDED
AS MWTMCAT10N.
•••;,„
g'�'P�� wh••:
ANGELA MAPNE2
Notary Rifle - State of Florida
' ` ' • _
My Comm. ExDlros Nov 26.201!
'ss
Commission # EE 117657
+�`.,,,�.�
Banded Tomuga Nalianal Nolary All,
FOR OFFICE VSE 0N1+Y:
Number of Opm inspecdow,
TotalTnsptctions:
(Divide open by total to get %ofopan inspections) ib hi-1
Permonmga:
Original permit fen x % open — $ Renemi fee
Example: 115 divided by 23 65(%)1 Si75(peamit fee) x .65=5113.75 (T Mewnl fec)
Revised 6WI2014