HomeMy WebLinkAbout7-10-2021_4;28;37 PMPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGMA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2003-0419 ADDRESS: 6 Flamenco, PSL 34952
I 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, 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
SIGNATURE
Wynne
Print Name
STATE OF FLORIDA
COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS 7th
BY Matthew Wynne
HAS PROVIDED
STATE OFj-LO21DA, County of St. Lucie
FOR OFFICE USE ONLY:
DAY OF October
1017121
DATE
IS PERSONALLY KNOWN TO ME
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
2021
OR
AS IDENTIFICATION.
'I'Ai., SUSAN LAFLEUR
AE ` MY COMMISSION I# GG 356204
>Pq EXPIRES: February23,2023
•�FY, ,F;°•` Bonded Tleu Notary Public Underunlem
Example: [15 divided by 23=.65(%)] $175(pennit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014