HomeMy WebLinkAboutPermit Renewals Nov 01 19,09:07a WBC 1234967A90 PA
PLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE,FL 34982
(772)462-1553 Fax 1772)462-1578 RECEIVED
PERAHT RENEWAL REQUEST NOV 01 2 0 19
ST, Lucie County, Permitting
PERMITNUMBER., 1901-0606 ADDRESS: 11 Kachina Lane, Port St. Lucie
Matthew Wynne 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,]
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
10/31/19
O'WNER,9LDR OR CON DATE
Matthew Wynne
Print Name
STATE OF FLORID A
COUNTY OF St.Lucie
ACKNOWLEDGED BEFORE ME THIS 31 St DAY OFOctober 12019
By Matthew Wynne WHO IS PERSONALLY KNIOWN TO ME OR
HAS PROVIDED AS IDENTIFICATION.
STATE 0 County -1.St. Lucie
SIGNAT[JltESUWLAREIJR
OF NOTARYE WC0MM=10H#GG3W204
EViRES.February U 2023
EWdedThmH0UWy. Un&vxbrs
FOR OFFICE 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
Example: [15 divided by23=.65(/S)] $175(permit fee)x.654113.75(renewal fee)
Revised 7121Y20A