HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONFee Due:',_� Recei t# Permit # Q .
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553
SPECIALTY PERMIT APPLICATION SC g Y���
St. �ucfe County
® Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address:
2. Parcel ID Number: 341 �4&14-74 j -000)9
office Use
Only
Section
Township
Range
Map Page
Zoning
an Use
Initials
3. Complete Description' of Project or Work Activity: Replace meter center with a combo pack
4. Owners Information
Name: Wynne Bldg. Corp
Address: 8000 S US # I
City: PSL State: FL
zip: 34952 Phone: 878-S513
6. Value of Construction: $ (oiad
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 nstruction and zoning
James W. Law
PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF O R OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS �_ DAY OF 20 -4 BY James W. Law
WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS PRODUCED JULIET LAW
NOTARY PUBLIC
As is rtFI IONS Juliet Law (Seal)9-p- �m# OF FLORIDA
SIGNA` JRE OF NOTARY TYPE OR PRINT NAME OF NOTARY EoreS 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