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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
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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