HomeMy WebLinkAboutMisc Letters 12/07/2016 10:39 1 ELITE ELECTRIC INC PAGE 03
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1604-0363 ADDRESS: 8 La Paloma Lane
1, John A Pankraz ,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 homeowner was up north
12/7/2016
OWNERA3L�,QR C"RACTOR SIGNATURE DATE
John A Pankraz
Print Name
STATE OF FLORIDA
COUNTY OF SL Lucie
ACKNOWLEDGED BEFORE ME THIS 7th DAY OF December 2016
.. John A Pankraz WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,Count3,of St. Lucie RD
"%, NANCY LLSLANGF010
qA4ft 6'e— MY COWUSSION 0(302o372
SVU�ESI ,12,202D
SIGNATURE OF IVOTARY S9§0.
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Pereentage:
Original permit fee: X%open = $—Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee)x.65=$l 13.75(renewal fee)
Revised 7/2112014 RECEjVEL
DEC /7 20t',;�