HomeMy WebLinkAboutMisc Letters JAN-05-2016 14:51 P.01
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Vax(772)462-1578
PERMIT RENEWAL REQUEST
PERMITNUMBER: 1506-0128 ADDRESS: 8725 TOMPSON POINT RD
I, STEVE SANDERS ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be fmaled. 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.
Justification HOMEOWNERS WERE OUT OF STATE UNTILL THIS JANUARY AND UNABLE TO SCHEDULE INSPECTION.
-e-A 'e5emll 01/05/2016
OWNEMLDR QR CONTRACTOR SIGNATURE DATE
STEVE SANDERS
Print Name
STATE OF FLORIDA
COUNTY OF PALM BEACH
ACKNOWLEDGED BEFORE ME THIS 05 DAY OF JANUARY ,2016
BY STEVE SANDERS WHO Is PERSONALLY KNOWN TO ME X .OR
HAS PROVIDED AS IDENTIFICATION.
S OF F PALM BEACH
S NATURE NOTARY SEAT,
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FOR OFFICE USE ONLY: ftIdedThIkv ofsryPuhfkUntlenydter�
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage_ `
Original permit fee: x%open = $ Renewal fee "a
Example: [15 divided by 23.65(%)] $175(permit fee)x.65=$113.75(renewal fee) ,
Revised 7/21/2014
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