HomeMy WebLinkAboutMisc Letters (2) PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
P4740 :11
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 F2X(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER- cove,
am requesting that the above permit be renewed. I
understand that 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 clurin t11e renewal period.
Justification [hWAAU PQ,;ft+
OW—LDR Q
B _R CONTRACTOR SIGNATURE DA
Aprint 4,me
nyo
STATE OF F�LO..
COLTNTYO
ACKNOWLEDGED BEFORE ME S DAY Of � I w
13Y e. WHO TS PERSONALLY KNOWN To M-F, OR
HAS PROVIDED AS IDENTIFICATION.
1,---82A1E,OF FLORID 0"ty'—Of
TAMMY ZIESAK
Notary Public-Sta(e al Florida
SIGNATOR OT 8
-.,JffNMm Expires Aug 25,201
Carrimission# FF 1,37629
ffii9-1
'OR OFFICE USE ONLY.-
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%opcn = $ Renewal fee
Example: (15 dividcd'by 21-.65(%)j $175(permit fee)x,65=$113.75(renewal fcc)
Revised 7/21/2014 RECEIVED
OCT 12