HomeMy WebLinkAboutMisc Letters 02/01/2016 13:22 9549773591 PERMITS PAGE 01/02
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PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVY,
Now~ FORT PIERCE,FL 34982
(772)4624-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
Pl3RTWTXUMBER: 1507-0219 ADDRESS., 854 SE CORTO TER
Richard Levinson w-n requesting that the above permit be renewed. i
understand that I must schedule and pass all required inspections for the permit to be finalod. Further,I
understand thkthis is a ONES RENEWAL and the permit shall expire should I not receive a
paMg mspecti6n during any six month period during the renewal period.
iuki. do re unable to schedule an inspection with the Homeowner int he time alloted
far arm t.
OWNER R (NIRAtTOR SIGNATURE DATE
Richard Levinson
Print Name
STATE OF FLORID
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS-__DAY OF—
BY Richard Levinson WHO IS PERSONALLY KNOWN TO 1,4F. X. OR
HAS PROVIDED AS IDENTIFICATION.
ST OFF ORIDA,�C
SHEFIFAWHYTE
9W.ARI My COMMISSION 0 rF 065032
EXPRES;000bgr21,2017
IfGNATOF NOTARY SE
FOR OFV ICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get Vo of open inspections)
Percentage:
Original permit fee: X%Opel) = $Renewal fee
Example: [15 divided by 23-.65(0/6)] S175(permit fee)x-65=4113.75(renewal tee)
REGE
Rcvisod 7121=4
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