HomeMy WebLinkAboutMisc Letters 1210812016 17:05 SHARKEY AIR �FAR)772 220 3787 8.0011002
PLANNING AND DEVEL0P91NT SERVICES DEPARTIINT
MA
®EO
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
---" FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMT RENEWAL REQUEST
PERMIT NUMBER: ADDRESS: .!
1, Vtam retPuesting that the above permit be renewed_ I
understand that I must schedule imdta s all required inspections for the permit to be haled. Further,l
understand that this is a ONE T NEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification
O LDR 'TO NA DA E
Print NAme
STATE OF FLffjbLj,
COUNTY OF
ACKNOWLEDGED BEFORE METHIS V " DAY OF C�xYL ,20-0
BY WFiO IS PERSONALLY KNOWN TO ME 'V OR.
HAS PROVIDED AS IDENTIFICATION,
STA FLORID ,
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OF NOTARY163 17
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FOR OFF XCE USE ONLY:
Number of Open Inspections: _
Total Inspections• _
(Divide open by total to get%of open inspections)
Percentage:
Original permit fee: x%open = $ Renewal fge -
Example: (15 divided by 23=.65(%)] $17S(permit fee)x.65=$113.7 (renewal fee) -
Revised 7/21/2014