HomeMy WebLinkAboutMisc Letters PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
# BUILDING AND CODE REGULATIONS U]VISION
1360 VIRGINIA AVE
FORT PIERCE,FL 34982 .
(772)462-1553 . Fax(772)462-1578
PERMIT RENEWAL:REQUEST '
t PERMIT NUMBER: 1�?D� `��YZ� ADDRESS:
I, CRAIG CANTRELLrequesting that the above:permh be renewed. I.
understand that=l must scheduie and pass:4,required inspections for the.permit to Fie.finaled. . Further, I
iit5derstarid that this is a ONE TIME RENEWA.I.':and the.permit sl ab expire shai ld T riot rece;Ve a
passing inspection during any six month period dur'tngthe rene vat period
.Iusti>icatioli i r�
O_WNE- LDR OR.CONTRACTOR SIGNATURE. DATE L. '
Print Name:
STATE OF FLORIDA"
C.oUNTY OF ss OCIE
ACKNOWIE.DGED i3EFORE'1vIE THIS . I5 DAY OF ����'w� _ :20
Ey CRA"IG CAIVTRELI: wxo Is rl xsarlAi i v x��ME x OR.
HAS PROVIDED` AS IDENTIFICATION.
STATE OF rLORIDA:"County of - L Lt 'lam
r*"Ili
DEBORAH.RUSSELL i
a°; `�, Notary Public ."State of Florida i
my Comm,Expires Nov 30,2Q18 k
SIGNATURE`OF;NOTARY
�'j 1°� Commission.#FF 179630
Bonded through National Notary Assn. .
FOR OFFICE USE ONLY:.
Nuiiiber of Open-Inspections:
Total Inspections
(Divide open by total:to get%of open inspections)
P.ercentage.;: "
Original permit fee; x%open = $ Renewal fee
Exampie: [15"divided by 23=.65(%)] $I75(penmit fee)x.65=$113.75(renew,al fee)
.Revised 7121/2014