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.
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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