HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
, `u L;)I,U:4 L Le
,1 V
° Building Permit Application
Planning and Development Servkes
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:1772)462-1S53 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 122M W.Angle Rd, Fort Pierce,FL 34945
Property Tax ID#: 133221100020005 Lot No.
Site Plan Name: Angle Road Block No.
Project Name: Verizan Amendment
DETAILED DESCRIPTION OF WORK:
The proposed project includes modifying ground based and tower mounted equipment.lnsW(1)EW52 Hybrid Cable,
existing(1)Dish(s)and(1)EW52 Hybrid cable to remain
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical —Gas Tank Gas Piping w Shutters Windows/Doors Pond
Electric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 15,000 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE Amerken Tower-Luse q)NTRACTOR:a ae�em*t
Name Angels Budd Name:Jonathan Crompton
Address-10 Pr+eaidential Way Company:J Crompton Electric
City. Woburn,Me State: Address:1290 Old Congress Ave
Zip Code: 01801 Fax: City: West Palm Beach State:FL
Phone No.813-507-8985 Zip Code: 33409 Fax:
E-Mail:tYoun90ea OW-net Phone No 561-%"W9
FM In fee simple Title Holder an nerd page I If different E-Mail p6rmWn9 Pt0n6 •00rn
from the Owner 11sted above) State or County License 5CC131151549
ff value of construction Is 2500 or more,a RECORDED Notice of Commencemem Is required.
N value of HAVC Is$7,5W or more.a RECORDED Notice of Commit b required.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: x Not Applicable
N a me:mdft Holdhgs LLC Name:
Address: an gm Ave Address:
City:v«o Beach City:
Zip: 329s Phone:wA 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF H—Gr-
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization x Physical Presence or Online Notarization
this day of 12020 by this +14 day of r 2020 by
Name of person making statement. Name of pe n making statement.
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of'RIa) Me* I�r
Commission No. (Seal) Commission No. pGOM21 OTARY PUBLI
C
XATE OF FLORI
. Canrng G1308E021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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