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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date 11/12/2019 Permit Number: q (L_
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RECEIVED
_ • _. Building Permit ApplicationNov 141o'g
Planning and Development5ervices
Building and Code Regulation plvislon Permitting pepart-
2300 Virginia Avenue,Fort Pierce FL 34982 St, Lucie
County
ent
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: Electrical
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Address: 3120 N A1A 1303, Fort Pierce, FL 34949
property Tax iD#: 1425-610-0134-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
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Wire new electric water heater in accordance with permit 1905-0250.
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
(electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: .__-..-.. .. Sq. Ft.of First Floor:
Cost of Construction:$ Soo Utilities: —Sewer —Septic Building Height:
2, hItir
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y J �:,.�•i�rzli.. ,a tai i>� .i.4w, $t- fir" 1
NameAshbel Gulliver Name:Tom G.Walton
Addres5:3120 N Al 1303 Company:L; Walton Electric, Inc. j
City: Fort Pierce State: Address:1135 17th Street
Zip Code: 34949 Fax: City:Vero Beach State:.l=L
Phone No. - Zip Code: 32960 Fax: 772-569-8906
E-Mail: Phone No 172-569-1647
Fill in fee simple Title Holder on next page(if different E-Mail waltonelectric@gmaiLcom !i
from the Owner listed above) State or County License EC13003596
If value of construction is$2500 or more,a RECORDED Notice of Commenceme t is required. ,
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. _ �G\(��� C
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address• Address: .._ --
City: --- State: City: _ State:
Zip: Phone ___ Zip: -Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: _ Address:
City: _ — City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby madeto obtain a permit to do the work and installation as indicated.
i certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any,applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such I
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,In all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. .
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RiECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR iiMPROYIEMENTS .TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU,INTEND TO OBTAIN FINANCING, CONSULT
WIT YOUR LENDER OR AN ATTO Y BEFORE RECORDING YQUIR NOTICE O CO CE NT."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of ContractorJLicense Holder
STATE OF FLOR,i�A STATE OF FLORI
COUNTY OF f _nA". Y1 �Ucy COUNTY OF fl ;`.ah 0tur.1l_—
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The orgoing instrument was acknowledged before me The forgoing instrgtpent was acknowledged before me
this day of bV _,26A by this, day of WOU�bLir 20K by
I Name of person making
gsstatement, Name of person making tement.
Personally Known `� OR Produced Identification Personally Known OR Produced Identification
Type of Identif Watt• Type of identificatlo "
Produced roduced
Notary Public state of FloriCa
4nI Newman Nofery Public Statel s Fl 'dd
mie6iertGG 22s4to . AprN Newman
Gimel MIMI= azz_imo oat
M Cant i 6 10
(Signat of Notaryubl- Sign ure of Nottayry Public-State F expires oan7,2pZz
Commission No. lqq (Seal) Co mission No. 4 1 D (Seal)7
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE]
COUNTERS REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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