HomeMy WebLinkAboutPermit Renewals PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
1 BUILDING AND CODE REGULATIONS DIVISION
® 2300 VIRGINIA.AVE
FORT.PMRCE,FL 34982
i (772)462-1553 Fax(772)462-1578
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PERMIT RENEWAL REQUEST
PERMIT,NUMBER: 1604-01:02 ADDRESS: 2550 S Brocksmith Rd
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1, CRS:Plumbing ,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 1 not receive a
passing inspection during any six month period during the renewal period.
Justifcatiori Needed:other extensive work:done.prior to.continuing to replace.cast iron pipe
with PVC DWV'piping.
'OWA,IkMLDR OR CONTRACTOR SIGNATURE DATE
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Reed Sudderth
Print Name
STATE OF-FLORIDA
COUNTY'OF 44 w
ACKNOWLED IGED.BEFORE ME THIS K{ DAY OF I>- .20 JLO
BY Reed::Sudderth _^ WHO IS PERSONALLY KNOWN TO XXX OR
HAS PROVIDED AS IDENTIFICATION.
ST OF FLO ty of StLucie -.---
° EDWARD D JENDON.
t •A;:'iP�'
GNATURE O _ car,r MY COMMISSION#FF1245s7
F NOT Y SEAL �y� , j y EXPIRES May 19,2018
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(4071 388.0153 FloridaNgar/Service.com
FOR.OFFICi USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to.get%of open inspections)
Percentage:,
Original permit fee: x%open - $ Renewal fee
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Example: [1 divided by 23=.65(%)] $175(permit-fee)x.65-$113.75(renewal fee)
Revised 7121!1014
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®EC 21 2016