HomeMy WebLinkAboutBuilding Permit Application A2P0045B- Excalibur- Building
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05.24.2021 Permit Number:
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:T-Mobile South, LLC
PROPOSED IMPROVEMENT LOCATION:
Address: 6189 N US HIGHWAY 1
Property Tax ID#: 1406-413-0003-000-8 Lot No.
Site Plan Name: Block No.
Project Name: A2P00456-Excalibur
DETAILED DESCRIPTION OF WORK:
Replace all existing telecom ground equipment with new equipment
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 _Shutters _Windows/Doors Pond
X Electric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 10,000 Utilities: _Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name T-Mobile South LLC Steve Nichols
Name:
Address:1300 Concord Terrace Suite 200 Company:ERICSSON INC
City: Sunrise State: Address:6300 Legacy Dr
Zip Code: 33323 Fax: City: Plano State:TX
Phone No. Zip Code: 75024 Fax:
E-Mail: Phone No 352-446-1241
Fill in fee simple Title Holder on next page(if different E-Mail steve.nichols@edcsson.com
from the Owner listed above) State or County License CGC1518237
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,5W or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:APx Engineering Group,LLC Name:wA
AddreS5:14471MiramarPar" Suite202 Address: NA
City: Miramar State: FL City: NIA State: NIA
Zip: a3027 Phone(954)744-+53e Zip: N/A Phone:NIA
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ,Not Applicable
Name:Mary Jane Spain CM) N am 2:NfA
Address:Po Box 1149 Address: NIA
City:Hobe Sound City:N/A
Zip: 33475 Phone: Zip: NIA 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.
5t.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 inWection.If you intend to obtain financing,consult
with lender oracattorney before co encing work or r4doriing your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner sigria Contractor/License Holder
STATE OF FLORIDA STATE FLORIDA
COUNTY OF t` yTI r COUNTY OF Lake
5worn.to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
_ hysical Presena a or Online Notarization : )=Physical Presence or Online Notarization
this day of T 2021 by this�tWay of May 2020 by
i
�� ,'� �.���ss• Steven Nichols
Name of son making statement. Name of person making statement.
Personally Known �' OR Produced Identification Personally Known OR Produced Identification XXX
Type of Identification Type of identification
Producedr Produced J DL
(signature of N ry Public-State of Florida) a of Notary Public-
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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