HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONDate: Fee Due: �' p Receipt# J fj hermit # 'A 0 � _ O-j SG,
a� 1
Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982 UCH
(772)462-I553
SPECIALTY PERMIT APPLICATION
Z Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed ❑ Demolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional papenvork required for specialty perinits
1. Location/Site Address: c-2 -7'-
2. Parcel ID Number: 341/-�/-/_ 0/— &oU /9 _
Office Use
Section
To►rmship
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: WVnne Bldg. Corp
Joao S' QSdi-
Address:
city: 705/— t=' State: FL
Zip: _�5.Phone: 878-5513
6. Value of Construction: $ /a 0-T) t O ()
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 regulatin onstruction and oni g
James W. Law I
PRINT OWNER OR CONTRACTOR NAME SIGNATURE OF OWN R OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS 7 DAY OF 20 BY James W. Law
WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS PRODUCED JULIET LAW
ARY PUBLIC
AS I NTIFI %rF:
TATE OF FLi?RiOA
Juliet Law (Seal)omm# EE846906SIG T E OF NOTARY TYPE OR PRINT NAME OF NOTARYCOMMISSION NUMBER EE 846906 XPIMS 10/28/2016
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