HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:_ o�t •O(Q 1G
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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 TYPE:
PROPOSED IMPROVEMENT LOCATION: n ew ova�Q
Address: Enterprise Road 01B U ) f
Property Tax ID#: 2428-133-0001-000-6 Lot No.
Site Plan Name: Ft Pierce 150'PIFLO67 Monopole Telecommunications Facility Block No.
Project Name: Ft Pierce 150'PIFL067 Monopole Telecommunications Facility
DETAILED DESCRIPTION OF WORK:
Installing new 150'Telecommunications Tower and compound area
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors
X Electric _Plumbing _Sprinklers _Generator `Roof Pitch-
Total Sq. Ft of Construction: 2500 Sq. Ft.of First Floor:
Cost of Construction:$ ?7Z OOO Utilities: _Sewer _Septic Building Height:
:OWNER/LESSEE: CONTRACTOR:
Name PI Tower Development LLC Name:Roman Whitney
Address:2320 Cascade Pointe Blvd,Suite 300 Company:The Gilly Development Corporation
City: Charlotte State: NC Address:115 LAKE ARI ETTA COURT
Zip Code: 28208 Fax: City: AUBURNDALE State:FL
Phone No. Zip Code: 33823 Fax:
E-Mail: Phone No(863)581-3406
Fill in fee simple Title Holder on next page(if different E-Mail romanwhitneyi @gmail.com
from the Owner listed above) State or County License CGC1516107
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name:B+T Group/John Kely Name:
Address:1717 s Boulder Avenue Address:
City: Tulsa State: OK City: State:
Zip: 74119 Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: X Not Applicable
Name:silver-Line Plastics Corp Name:
Address:900 Riverside Drive Address:
City:Asheville,NO City:
Zip: 28804 Phone:828.252,8755x1250 Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to 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
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 RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of w/ne Less a/Contractor as Agent for Owner Signature of Contractor/Licen Hol r
41
_STATE OF Ft6Rtf}A STATE OF FLORIDA
COUNTY OF COUNTY OF 'Zo LIG
The forgoing instrument wa acknowledged before me The forgoing instrument was acknowledged before me
this 2?J,day of 20;P by this UfNay of Sfr r L 20AQ by
Ron/ t ,si���2 Raliy*,aaa l,.�e. t��.��weY
Name of person making statement. Name of person making statement.
kicSIM I Person II Known OR Produced Identification
OR Pr,duced l$i� Y
Type of Identification Notary Public Type o Ide tification
g Co.,North Car, li�i�odu ed �P+ys r L'tcwo�.
Produced lertbur 0(a�ly
OII
CM Mission Expires Oct.0 ,20.L) W%60
(Signatu e bf Notary Public-State of f4wida)Np2 (Signature of No"thry Pu c State of Florida Terry L Johnson
Notary Public,State of Florida
Commission No.20H3179000 ar (Seal) Commission No.C&Jt)rSa`TJ MyCoibjrpiresAugust 28,2 2
Commission No.66248279
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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