HomeMy WebLinkAboutMisc Letters JAN-05-2016 TUE 09 56 AM CENTRAL SCHEDULING FAX No. 3212686138 PAN
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PLANNING AND DE'VELOPMEN'T SERVICES DEPARTMENT
Building and Code Regulations Divilsiolt
2300 vIAGlNrA AVE.
FORT P..IERCK,FL 34982
(772)462,1553 Ric(712)462-1578
PERMIT RENEWAL REQUEST
Ir
P tvIIT NUMB i: ADDRESS:�A 11111
i, am requesting that�above permit be renewed. Y
uaz azstatrct that I mast s-c—hedule—add pass all re cared stns ect3ons ler pearX►xit to be finaled. Fuither,I
understand that this is a ONE ,[TME RE+I+FEWAL and a pire should I not receive a
passing inspection during any six month period dtrrirtg the renewal pezlod.
Justification
OWNEItIJ3 I,3I, CONTRACTOR SIGNATURE DATE .T
.,.,fit..
STATE OF F0�
C
OUNTX Of
AC EDGED 68FORE W THIS _DAY Of 2{1
8Y _J � VW IS PERS(?�T�.Y,SC MO FO l� QR
HAS MOVIDE J , � AS=NTIFIC&ION.
S TE OF FLORIDA,County of —
,,,,"., �Catherit►e"K�as<ger'
U Rr C-NOTARY
O1�c�r,C�,11h�"
f2IW01/18
DB
O4WISTIFLURN ADTYNA1
FO)t OT''Iuu YJSE ONLY:
Number of Open bspections:
Total Inspectioms•
(Divide open by total to get V,of open inspettimos)
Percentage:
Original pen nit fee: -x%open - _Ramal$oe
Exvmple: [15 divided by 23=.6S["/0)] S175(petrnit-fec),c.654119.75(ronewsl i$4)
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