HomeMy WebLinkAboutMisc Letters (2) 12/07/2016 10:'39 1 ELITE ELECTRIC INC PAGE 03
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
s j BUILDING AND CODE REGULATIONS DIVISION
u ' 2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax(772)462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 1604-0363 0� ADDRESS: 8 La Paloma Lane
I, 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
OWNE .OR COVRACTOR SIGNATURE DATE
John A Pankraz
Print Name
I
i
STATE OF FLORIDA
COUNTY OF S.I.wde
ACKNOWLEDGED BEFORE ME THIS 7th DAY OF December 2016
BY John A Pankraz WHO IS PERSONALLY KNOWN TO ME x OR
I
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA,County of St. Lucie
NANCYLEELANGFORD
-
SIGNATURE OF VOTARY S / EMMES:O L b r 2,2032
/�1�, ��tz,zo2o
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FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get%of open inspections)
Percentage: I
Original permit fee: x%open = $ Renewal fee
Example: [15 divided by 23=.65(%)1 $175(permit fee)x.65=$113.75(renewal fee)
Revised 7/21/20I4
REcjV.
DEC /7 2