HomeMy WebLinkAboutMisc Letters PLANNING.AND DEVELOPMENT SERVICE&DEPARTMENT
" - BUILDING AND.CODE REGULATIONS DIVISION`
f - _ 2300.VIRGIMA AVE
FORT PIERCE,FL 34982
(772)462-1553. Fox(772)462--1578
PERNIIT'RENEWAL REQUEST
PERMTr NUMBER: l�J OS b ' "I ADDRESS:_�r�-7 1 D Sea q rQ,�5S &f
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I: �cx�D�fC_ II�G�..,�� am r: ue5tin 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
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OWNERBLDR OR:CONTRACTOR SIGNATURE. DATE
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,Print Naine
STATE OF FLORID
COUNTY OF
ACKNOWLEDGED BEFORE ME THIS.: DAY OF n 1 .20
BY 11P�L��e ( ��,n n WHO IS PERSONALLY KNOWN'TO ME ,OR.
HAS PROVIDED AS.IDENTIFICATION:
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TE OF FLORIDA,County of ;1' Lcc-e— DEBORAHRUSSELL
Notary Public-State of Honda {
SIGNATURE OF.NOTARY 1 8
omm.Expires Nov 30,201 1'.
Commission # FF 179630
''�` 4enr'ed through Plztlanal P!:i2r{ ...
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections: .
(Divide open by:total to get%of open_inspections).
Percentage:
Original permit fee:. _ x:%a open = $ Renewal fee:
Ezaniple: [15 divided by 23=.65 f/o)] $175(pemnit.fee)x..65=$113,75(renewal.:fee):.
Revised 7212014