HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONFee Due: 7--130
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+ermit # 0S 0 - 00 4 tj
. Planning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553 St.
SPECIALTY PERMIT APPLICATION
® Electrical
❑ Plumbing
❑ HVAC
❑ Fence
❑ Shed
Q Demolition
❑ Gas
❑ Siding
See page 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: 'yV-' rd
2. Parcel ID Number: 3414-501-1701-009 #/
SCANNED
kUCBy
Ie CoU.ty
Office Use
Only
Section
Township
Range
Map Page
Zoning
Land 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 Bldg. Corp
Address: 8000 S US # I
City: PSL State: FL
Zip: 34952 Phone: 878-5513
6. Value of Construction: $ /o7�`O 00
S. Contractors Information
FL Reg/Cert # ER 0000122
County Cert # 2098
Business Name: Laws 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 regulapticnstruction and�g
James W. LawPRINT OWNER OR CONTRACTOR NAME IGNATURE OF OWNER OR CONTRACTOR
STATE OF FLORIDA, COUNTY OF St. Lucie
ACKNOWLEDGED BEFORE ME THIS 6"# DAY OF 20 / -?—BY James W. Law
JUUET LAW
WHO IS PERSONALLY KNOWN TO ME X OR WHO HAS PRODUCED TARP PUBLIC
AS ENTIFICATI 17ASTATE OF FLORIDA
Juliet Law (Seal) WEWreslO/28=16
Comm# EE848906
SI A URE OF• NOTARY TYPE OR PRINT NAME OF NOTARY
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