HomeMy WebLinkAboutrenewalPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGINIA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
PERMIT RENEWAL REQUEST
PERMIT NUMBER: 2103-0569 ADDRESS: 48 CAMINO DEL RIO
1 MATT -HEW LYLE 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 SHORT-HANDED DUE TO COVID
OWNER/BLDR OR CONTRACTOR SIGNATURE DATE
MATTHEW LYLE WYNNE
Print Name
STATE OF FLORIDA
COUNTY OF ST. LUCIE
ACKNOWLEDGED BEFORE ME THIS 6 -7*' DAY OF V E G E J'Y/ g EK , 20,21
BY MATTHEW LYLE WYNNE WHO IS PERSONALLY KNOWN TO ME X OR
HAS PROVIDED AS IDENTIFICATION.
STATE OF FLORIDA, Comte of ST, LU CI E
^*? DOROTHY ANN BASKIN
MY COMMISSION #HH 045443
S EXPIRES: October 2, 2024
`•.,EaF "c: Swded Thm Notary Public Underwriters
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 = S Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014