HomeMy WebLinkAboutMisc Letters PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
Building and Code Regulations Division
COUNTY 2300 VIRGINIA AVE.
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: /� VV�9FADDRESS: 1606 MrAllOrd CfFc�4 Perce- 1--1, 3gq&D
I; James 18LUv eg ,am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. 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 Owner gnus J Ao(4_j , Ors' lyt��Pr�lcs�
OWNER/BLDR OR CONTRACTOR SIGNATURE IJATE
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Print Name
STATE OF FLORIDA -
COUNTY OF
ACKNOWLEDGED BEFORE ME TIJII��S pp _DAY OF 920�
BYQ&X"&
g g "" v WHO ISP ONALLY KNOWN TOME �OR
HAS P DED AS IDENTIFICATION.
STATE O FLORIDA,County of
AUDREY B.HUMPHREY
SIGNA OF NODRY SEAL =•: r MY COMMISSION#FF 174772
• EXPIRES:March 6,2019
Bonded Thru Notary Public Underwriters
,
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections: o sialunuapuN oggnd AMON Mi RPM
/o61.0V9
(Divide open by total to get of open inspections)
6lOZ'9 4�aEW�S3dIdX3
Percentage:
ZLLbLI.dd#NOISSIW1N00 hW
Original permit fee: x%open = $ Renewal fee A38HdnnH'9 A3danv
Example: [15 divided by 23=.65(0/o)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 6/24/2014 _
JAN