HomeMy WebLinkAboutA2P0036B L600 BP app fully executed870159 TMO L600 A2P0036B
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
... wilding Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT TYPE: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 1100 Dyer Road
Property Tax I D #: 34-14-501-0713-2506
Site Plan Name:
Project Name: T-Mobile L600 870159
DETAILED DESCRIPTION OF WORK..
T-Mobile L600 is proposing to swap (3) antennas for (3) new antennas, (3) RRUs for (6) RRUs
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit -- check all that apply:
_Mechanical ® Gas Tank _ Gas Piping T Shutters _ Wlndows/Doors
X Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 10,000
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
Name Crown Castle
Address: 6420 Congress Ave Suite 2000
City: Boca Raton State: FL
Zip Code: 33487 Fax:
Phone No. 561-544-4965
E-Mail: sflpermits@crowncastie.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Dan Ault
Company:Olin Wayne Companies, Inc
Address: 3060 Orange Grove Trail
City: Naples State: FL
Zip Code: 34120 Fax:
Phone No 239.776,5884
E-Mail sfipermitsgcrowncastle.com
State or County License CGC1522173
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.
DESIGN r-nl tIvUl NEER:
Not Applicable
Name: MORTGAGE COMPANY: Not AP
Address: Name: Applicable
City: Address:
State, City:
Zip: Phone State:
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Address:
d City:
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Name: City.
Phone Zip
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not
Not Applicable
La n., L
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S Applicable BONDING C
Name: Global Signal Semvpn LLC OMPANY: Not Applicable
Ad dreSS: 4017 Rd Name.,
—
City: McMurray, PA Address:
Zip: City:
t Phone:
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
i
which is n 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 ANATTORNEY BEFORE RECORDING YOU
1 5 NOTICE OF COENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF k1 - -
U
The forgoing instrument was acknowledged before me
this _L-
t�d.y.f T)e M(� 201.,g by
Name of person making statement,
Personally Known 1�1� OR Produced Identification
Type of Identification
Produced
of
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cto cease —ehid-14oldler ,
STATE OF FLORI
COUNTY OF !!�1�
The forgoing instrument was acknowledged before me
this _M day of M_ 202,--, by
Name of person making statement.
Personally Known. V OR Produced Identification
Type of Identificat'
Produced
(5ignof Notary Public- 5
ICHELLE MARIE RODRIG JE ure of Notat`e!y4t8°tv
Nptary Public - State of Florida ""4 N'Taf-V Pul3fle
Commission No,
eat} Commission # HH f
Sate of Florid
Linda
62053Co mission No.
Palcizzoi�Sealj
y Comm. Expires Nov 15, 2024
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...Bonded through National Nota
Expires 0410I-'/M22
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