HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COM L TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: Mile Post 145,Tumpike Operations,Port St.Lucie,FL 34984-Parcel ID:3431-122-0001-000-5 Sec/Town/Range:31/36S/40E
Legal Description: 313640 FROM SECOR OF SEC RUN N89S901W749.3 FTTOPOBAND TO A CURVE CONCNE,R OF 7839.44 FT,THNL ALG ARC 850.72 FT,TNN 133831 W4682 FT MILTONLI OF SEC,THSNM59WS30 FT MILTON 114COR.TH
5001401 E5385FTMiLTOS 114 COR THS 89 59 01 E1900 FTMILTOPOBIESSTRATPARTOFSEC SOUNOEDON THESBY SIJ OF SEC,ON THEWBYWJJ OF 3E 1l4 ANDWUOFNEIMOFSECANDONTHEEBYTNEWRDRIWLIOFFLORIDATURNPOIE(SR-91}(89.60AC)
Property Tax ID#:
3431-122-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Fort Pierce Tower Removal
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Removal of unused communications tower at the Highway Patrol Station K, located at the Fort Pierce
Service Station on the Florida Turnpike. Tower will be removed utilizing a crane.truck and will be
loaded into a dumpster for transportation off site. Project is for the Florida Department of
Transportation PO1783871 .
CONSTRUCTION INFORMATION:
Additional wor to be performed under this permit—c ec a a)PTY:
HVAC ; Gas Tank ❑Gas Piping S utters a Windows/Doors
Electric 0 Plumbing Sprinklers ElG nerator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of irst Floor:
Cost of Construction:S. 32,282.13 Utilities: Sei ver 1:1 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: Kad L.carlson
Address: Compan : Tower Systems South, Inc.
City: State:_ Address 3075 North Forsyth Rd.
Zip Code: Fax: City: Winter Park State:FL
Phone No. Zip Cod : 32792 Fax: (407)681-0501
E-Mail: Phone N (407)681-0501
Fill in fee simple Title Holder on next page(if different E-Mail: hills@towersystems.com
from the Owner'listed above) State or County License: CGC1515834
If value of construction is$2500 or more,a RECORDED Notice of Commenc ment is required.
e
SUP_PLEMENTALCONSTR:OCTION LWAMOMM ON .
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:Kar L.carlson
Address:^� ��T � nW�,� _ ��,3,-,� —To Address:
City: State: City: winte Park State:
Zip. Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: _Not Applicable
Name: i Name:Holmes,Murphy&Associates,LLC
Address:3075 North Forsyth Rd. Address: 5120 S.Solberg Avenue
City: City:Sioux Falls.SD
Zip: Phone: Zip: 57108 Phone:(605)336-1090
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtai i a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of permit.
St. Lucie County makes no representation that is granting a permit will author ze thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaw or and covenants that may restrict or prohibit such
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.Luc a County Amendments.
The following building permit applications are exempt from undergoing a full oncurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and iccessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement ML st be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signure o ontractor/License Holder
STATE OF FLORIDA STATE C F FLORIDA
COUNTY OF COUN OF Orange
The forgoing,instrument was acknowledged before me The forgo ng instrument was acknowledged before me
this day of ,20_ by this 21 Jay of June 20 l8 by
Kari L.Carlson
Name of person making statement I dame of person making statement
Personally Known OR Produced Identification Personalli r Known x OR Produced Identi_fc-anon°, �{
Type of Identification Type of Ic entification
Produced Produced ""Z a;OIAN na%f'6rlaaS-
z� ��En(�F�7,i'IR1�SSf0�'M GrG�5�ft7
M!% T�1TIiiS iorr xpioe
of
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State o Flori&4 • • C�=, -•
Commission No. (Seal) Commission No. GG 35672 (Seal)'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17