HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONDate: A 6 '% V I Fee Due:
Permit #
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
M2)462-1553
SPECIALTY PERMIT APPLICATION
® Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: Z l0 —_/_ l-;�
2. Parcel ID Number: 34 / J-_Q1-/W,_000
o/lice Use
Only
Section
Township
Range
Map Page
Zoning Ian
Use
Initials
3. Complete Description' of Project or Work Activity: Replace meter center with a combo pack at each address
4. Owners Information
Name: Wynne Bldl;. Corp
Address: 8000 S US # I
City: PSL State: FL
zip: 34952 Phone: 878-5513
S. Contractors Information
FLReg/Cert # ER 0000122
County Cert # 2098
Business Name: Law's Electric, Inc.
Phone: 772-971-4512 Fax: 772-878-3347
6. Value of Construction: $ �� .450
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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 regulati g construction and zo in
James W. Law
PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWNER OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF St. Lucie _ /
ACKNOWLEDGED BEFORE ME THIS L DAY OF 20 ! 5� . BY James W. Law
WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS PRODUCED DW& JULiET LAW
NOTARY PUBLIC
ASS DENT STATE OF FLORIDA
�_ _ Juliet Law (seal) . Comm# EE846906
SI Or NOTARY TYPE OR PRINT NAME OF NOTARY Expires 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 $7500.00
Revised 04/26/2010