HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION' BE ACCEPTED
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Date: • / V Permit Number: / `1 002
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Building Permit Application
Planning and Development Services A2P0045B
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: Building
Address: 6189 N. US Hwy 1 Fort Pierce, FL 34946
Legal Description: 6 34 40 FROM NW COR OF S 112 OF S 112 OF NE 1/4 OF SE 114 RUN E 370.23 FT M/L TO W R/W LI US 1, TH S 18 DEG 21 MIN 34
SEC E 488.91 FT, TH WLY // TO N BDRY LITO W LI E 1/2 OF SE 1/4, TH N 462.3 FT M/L TO POB-LESS TO SRD AS IN DBK 88-560, 562- (4.67 AC) (OR 760-818)
Property Tax ID #. 1406-413-0003-000-8
Site Plan Name:
Project Name: T-Mobile Site # A2P0045B
Setbacks Front Back: Right Side
Upgrade of existing wireless equipment
Left Side:
Lot No.
Block No.
or to under
E]Gas
this check aapply:
n�cWindows/Doo
,j
L
❑HVAC Tank
OGas Pi ing_
Shutters
rs
11 Electric 0 Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 15,000.00
Utilities:Sewer [] Septic
Building Height:
01NNER/LESSEE
�` h
4 CONTRACTOR
Name T-Mobile
Name: Daniel Ault
Address: 1300 Concord Terrace #200
City: Sunrise State: FL
Zip Code: 33323 Fax: 954-623-5039
Phone No. 954-854-9863
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: dolores.alcantara@civilsolutionsne.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
anies.comolinwa necom
E-Mail: danault @ Y P
State or County License: CGC1522173
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applica
Name: Morrison Hershfield
Address: Two South University Drive Suite 245
City; Plantation State: FL
Zip: 33324 Phone: (954)577-4655
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: FrankK.Spain
Address: P.o.Box1149
City; Hobe South
Zip: 33475 Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name: _
Address:
City:_
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
ROING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
imp ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo ee�, a first . spection. If you intend to obtain financing, consult with lender or an attorney before
commelt i wo r recording our Notice of Commencement.
signature-of.O.wner/Agent ssee LSig'na u ract f icense--Holden
COUNTY OF STATEOFFLORIDA (� STATE OF FLORIDA blv�� �J
COUNTY OF
The for.Wing instru t was a knowled ed before me The f rgQing instru t was ckn wI dged before me
this' day of 20by this day of '�- l ,P 4z 20_Wby
(Name of person acknowledging) (Name of person acknowledging)
(Signature o otary Public- Sf ate of� Florida )
Personally Known -----o �efduced Identification
Type of Identificatio
Commission No. ? ,'� •,` Notary MA - State of florida
My Com Expires Mar 21, 2017
Commission # FF 001615
Revised 07/1
(Signature of Notar#Public- State of Florida" �pfhw 3pp•.;'G
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Personally Known OR Produced$I t;fica
Type of IdentificaYon Produced
3717 7
Commission No. 61-'6% lotSta� .•' O
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VEGETATION
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