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HomeMy WebLinkAboutSUBMITTED PAPERSon Date: Fee Duey; , Q p Receipt# Permit # Planning & Development Services Building & Code Regulations Division SCANNED 2300 Virginia Ave. BY Fort Pierce, FL 34982 St. Lucie G+�u (772)462-1553 I1t1/ SPECIALTY PERMIT APPLICATION IN Electrical ❑ Plumbing ❑ HVAC ❑ Fence ❑ Shed ❑ Demolition ❑ Gas ❑ Siding Seepage 2 for instructions and additional paperwork required for specialty permits 1. Location/Site Address: 9 2. Parcel ID Number: 3414-501-1701-000/9 #/ Office Use Section To,,vnship Range Map Page Zoning Land Use Initials Only 3. Complete Description' of Project or work Activity: Replace meter center with a combo pack at each address 4. Owners Information Name: Wynne Bldg. Corp Address: 8000 S US # I City: PSL State: FL Zip: 34952 Phone: 878-5513 6. Value of Construction: $ l , L'J4 5. Contractors Information FL Reg/Cert # ER 0000122 County Cert # 2098 Business Name: Law's Electric, Inc. Phone: 772-971-4512 Fax: 772-878-3347 ---------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- OWNER's AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be done in compliance with all applicable laws regulating 'o str� and zoning James W. Law�� PRINT OWNER OR CONTRACTOR NAME % SIGNATURE OF OWNER OR CONTRACTOR STATE OF FLORIDA, COUNTY OF St. Lucie ACKNOWLEDGED BEFORE ME THIS;%s, DAY OF �% 20 13 , BY James W. Law WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS PRODUCED .IuuET LAWTARY PUBLIC AS I NTIFICATION. STATE CIF FLORIDA Juliet Law (Seal) -AW Comm# EE846906 StGNAlFbRE OF NOTARY TYPE OR PRINT NAME OF NOTARY E%pIrAS 10/28/2016 COMMISSION NUMBER EE 846906 NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER S7500.00 Revised 04/26/2010 STATE OF FLORiQA / COUNTY OF Swor tqq and subsc ' eq.before me this 1 b day of i oiGA 201 , by J/90 - ( LVf 4 &ez- _ Who is personally known to me or who has produced as identification. - Notary Public, State of Florida Signature of Notary.:"°'"�.b,o LUZ At]Pd7ANA ARTEAGA R- - Commission Number: S alM En 0111912031 . 0tary Public, Stets of Florida COMMiSsi0h# pp936596 .My.-C.Omm. expires:OCL 27, 9013