HomeMy WebLinkAboutProject Information RECEI`'�D
8476469
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
PERMITNUMBER: SLC 1508-0420 ADDRESS: 8104 Lakeland Blvd. Fort Pierce, FL 34951
I, Quinn Roberts ,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 Final inspection completed but changed to partial approval trying to resolve
issues so mit can be closed.
/ 16?/2 8//
OWNER/BLDR R CO TO SIGNA DATE
Quinn Robe s
Print Name Amber Flanker
NOTARY PUBLIC
STATE OF FLORIDA
STATE OF FLORIDA Expires/ Comm#FF970934
COUNTY OF f_ _ �'- te�0 Expires 7/11/2020
ACKNOWLEDGED BEFORE ME THIS p DAY OF e 40../ 20I L
BY Quinn Roberts WHO IS PERSONALLY KNOWN TOME y/ OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF I IDA,C ty of
SIGNAFNO'TARY SEAL
FOR OFFICE USE ONLY: ` t6
Number of Open Inspections: a
Total Inspections: ��Z
(Divide open by total to get%of open inspections)
Percentage: $`� s ,r.�6
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(0/o)] $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/2014