HomeMy WebLinkAboutConpleted applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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17 ' . Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 12200 W- Angle Rd, Fort Pierce. FL 34945
Property Tax ID #: 133221100020005 Lot No.
Site Plan Name: Angle Road
Project Name: Verizon Amendment
Block No.
I DETAILED DESCRIPTION OF WORK: I
The proposed project includes modifying ground based and tower mounted equipment. Install (1) EW52 Hybrid Cable,
existing (1) Dish(s) and (1) EW52 Hybrid cable to remain
New Electrical Meter Second Electrical Meter,
Fc—oNSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Electric
Gas Tank
— Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 15,000
_ Gas Piping
_ Sprinklers
„Shutters _ Windows/Doors _ Pond
_ Generator T Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWN ERAESSEE: American Tower- Lessee
CONTRACTOR: J Crompton Electric
Name Angola Budd
Name., Jonathan Crompton
Address:10 Presidential 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. 813-507-9985
Zip Code: 33409 Fax:
E-Mail: lyoung@teogroup.net
Phone No 561-588-6559
Fill In fee simple Title Holder on next page ( If different
E-Mail permitting@jcromptonelectric.com
from the Owner listed above)
State or County License 5CC131151549
If value of construction Is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNEiV 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
Name: 1n*b"o vLLc
Name:
Address: len 9wth A-
Address:
City: v— e.wh
City:
Zip: Phone:
Zip: MW Phone: wA
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 ermlt holder to build the subject structure
which Is in conflict with any applicable Home Owners Association rules, bylaws qr an covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed or 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 twke 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 tender or an attdnev before commencing work or recording vour Notice of Commencement.
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Signature of Ow / Lessee/Contractor as Agent for Owner
ntractor/License Holder
Signature of:10RIDA
STATE OF F IDA
STATE OF
COUNTY OF ►,..moo
COUNTY OF --
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this ao day of o2020 by
Av,Wm Gampbn
this ax day of t, 2020 by
Jonathan crWV4W
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
A Af..A a-.L�
Produced
6=26"-
(Signature of Notary Public- Sta f Flory 10MM
Ignature of Notary Public- State of PAIIA Waft
NOTARY PUSUC
N TARY PUBLIC
Commission No. 000e M STATE OF FLORIC
ACommission No. aooee321 AmmstwMbf FLORIDA
. Cornn (3GOMI
Ca mw G00=1
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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