HomeMy WebLinkAboutBuilding Permit App-original sentAll APPLICABLE INFO MUST, BE COMPLEi'ED FOR ' APPUCATIONTOBEACCEPTED"
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evilaiitg. , abdG OdeRe an, Cornmercial Residential
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2300 VirgW0',Avenue,,'Fdrt Pierce FL -14982•
Phone:.;(772) 462�-1553,Fa,)(.:(7,72)%461=1578
Property Tax 1D#: 142&.600-0088-000-3
Lot No::
Site Plan Name':.
Block No.
Prdiect Name::.Verizoh Wirdess.-Site#128"
070.7
At, equipment platform, remove/replace
coMmunicatiqn"cabiftets. Also upgrad&el&trica 1panel.
New Electrical'Meter Siecond,Eledri :1 Met&
ca
Additional, work to be Derf*M qd under -thi.s,.Oermit-check-all ,that apply:
_Mechanical; . Gas Tank Gas Piping Shutters:
—Windows/Doors Pond
_'Electric PluM 1 b n:
g: Sprinklers Generpt r Roof
.0 Pitch
Tota [Sq.. Ft.. of Construction:
Sq. Ft. of First Floor:
CostofConstruction.- $ 21,000 Wilitits: Sewer Septic Odilding.Height
Name Verizon Wireless, e-.Lessee
AddParkway
ress.- I----"TelecomP 'k 1. -
"Cit -;ya, MPA T4 State.
Zip Code: 33637,
Fax:
Phone um 411 0-052=3860 - Paul Bailey/Agent
E=Mail: pkvl',Oail-eYeca.aWir6l,etg.c,oriT
Filltinlee,simple TitleMolder on next page (11, dift6rent
from the Owner listed above).
City: JUpKer FL
StatL
Zip Code: 33478 Fax:
Phone No (561) 7711170677
E-Mailservice@advancedcommtech.n,ej
State -ofCounty License, C
GC1521987
lfiralueof.HAVC:is�$7,SWormore; -a,RECORDED ,Notit f 0 Commence.mentisrequired,
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SUPPLEMENTAL CONSTRULMON UEN IA f9f 1NFORMATI ON:
DESICaNER/ENGINEER, Not Applicable MORTGAGE COMPANY: Not Applicable
Na me: Hoo cMty9 M rc8VR Tole= L7yign Name:
Address: r+ A Address:
City; T State. 34949 State:
Zip; o a Phone7mew-'im Phone:
HOLDER,FEE SIMPLE TITLE }..
Address: d 310ONAIA
CZip: 34949 Phone:
JtVLF-P-'-.
i COMPANY:Not Applicable
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. Luele Counmakes 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 andd 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 fallowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another recut -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 attornev before commencing work or recording your fllatice oLCommencement.
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Signatur4 of Owner/ L ssee Contractor Agent for Owner
Signa or/License Holder
STATE OF FLORIDA
STATE OF FL
COUNTY OF �t
COUNTY 0F®1? _
Sworn to (or affirrnedl and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Presence or Online Notarization
_ P sical Pre
R
`3� Physical Pres nce or Online Notarization
this j day of - UUN 2024 by
this day of 20 bbyt
S
Name of person making staterent.
Name of person makingstatement.
s
Personally Known OR Produced identification
Personalty Known OR Produced ldent icaticrn
'
Type of Identification
Type of IdeAtification,Q
g
Produced _
Produced �i4
� �
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{Signature o hiotary Pu b �
(SignaturA of Notary Public- State of Florida }
x ieLALO € E Sr4:tl" -E SABOL
ter
Com{rsrissionrylt�. {
Commission Dior fl 1'i (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETA"nON
SEA TURTLE
MANGROVE
COUNTER
REVIEW
i REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
ELATE
RECEIVED
RATE
COMPLETED
Rev. 5/b/Ltt