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HomeMy WebLinkAboutMisc Letters 11/05/2015 13:15 9549773591 PERMITS PAGE 01/02 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 `lSo41-ICA- aO415- 000-6 PERMIT NUMBER: SLC,11504-0516/955 ADDRESS: 13515 S INDIAN RIVED DR APT 706 >, Richard Levinson am requesting that the above permit be renewed. I understand that I must schedule and pass al.l xequired inspections for the permit to be finaled. Further, I understand that this is a ONE TIME RENEWAL and the permit shall expire should T riot receive a passing inspection during any six month period during the renewal period. J st... catiN Hortkeowner was unable to have the inspection performed in the time alloted. H is w y'a available for the inspection upon the renewal of the permit. \\�'_tI_� 15 hs OWNER/ C-CMTRACTOR SIGNATURE D Print Name STATE OF FLORIDA COUNTY OF nn,, ll ACKNO LEDGED BEFORE-MG THIS�DAY OFNy V ,20 1 S BY r, I��(� ,s///l,�(�/j WIIC)1S riCCtSQN�Li_Y tCNUWN TAME ,OR IiAS PROVIDED AS MENTIFICATION. STA F FL 1tIDA, ty,Counof W M. r SHEHIFA>N" 1" K MY COMM1SSJ0N b FF066092 t EXPIRES:OotoberQ1,2017 -STONATUIP FNOTARY SEAL 8netl9d7BtVNalarypubllcUnennvrkero FOR O.MCE USE ONLY: �^ Number of Open inspections: Total hispections: (Divide open by total to get°/n of open inspections) Percentage: Original permit fee: x%open = $ Renewal fee Example: [15 divided by 23=_65(9/o)] $175(permit fee)x.65-$113.75(renewal fee) Revised 7/21/2014