HomeMy WebLinkAboutRenewal PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
r BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
® FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: SLC 1511-0244 ADDRESS: 7679 Wexford Way Port Saint Lucie, FL 34986
Boysie Ramdial 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 We ran into issues with ordering the product and with the homeowner's schedule
that prevented us from completing this job.
05/19/16
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
Boysie Ramdial
Print Name
STATE OF FLORIDA
COUNTY OF Lake
ACKNOWLEDGED BEFORE ME THIS 19 DAY OF May 2016
BY Boysie Ramdial WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE FL ounty of Lake
Amina F**er
NorA"pMW
SIGNATURE OF NOTARY SEAL 3TATEOPRD111OA
' r E�Ires 7/11/2020
CWOOFFUMN
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ 1rJ •�C Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x.65=$113.75 (renewal fee)
Revised 7/21/2014