HomeMy WebLinkAboutA2P0038B BP App (Signed)AII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Sr: Luclu =-ttrj## -Building Permit Application
Plonning ond Development Services
Building ond Code Regulotion Division
230O Virginio Avenue, Fort Pierce FL 34982
Phone: 17721 462-t553 Fax:17721 462-1578
Commercial X Residential
PERMIT APPLICATION FOR: ANTENNA TOWCr
PROPOSED IMPROVEMENT LOCATION:
address: 375 E Midwav Road Fort Pierce, FL 34982
Property Tax lD fl:
Site Plan Name:
3403-502-0055-020-3 Lot No
Block No
Project Name:A2P00388 - Excalibur Proiect
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter (Affidavit requ ired)
CONSTRUCTION INFORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters windows/Doors Pon d
PitchX Electric _ Plumbing _ Sprinklers _ Generator Roof
Sq. Ft. of First Floor
Cost of Construction: S s20.000 Utilities:_ Sewer _ Septic Building Height:300'
lf value of construdion is 2500 or more, a RECORDED Notice of Commencement is required,
lf value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name T-Mobile South LLC
Address: 1300 Concord Terrace Suite 200
City Sunrise State: Fl
Zip Code
Company
Address:
Ericsson. lnc.
6300 Leoacv Dr
City Plano State:_fL
Zip Code:
Phone No
Fax
352446-1241
E-Mail steve.nichols@ericsson.com
State or County License cGC151823
Removinq and replacing antennas and equipment at alreadv exsistinq T-Mobile's wireless facilitv.
Total Sq. Ft of Construction: _
F ax:______j!rA_
Phone No. 561-226-9287
E-Mail: ccastro@sbasite.com
Fill in fee simple Title Holder on next pate ( if different
from the Owner listed above)
Name: Steve Nichols
,efore me of _XL Physical Presence or _ Online Notarization
o 21 bv Steven Nichols
Eondod Thru Pt/blic UndeMrflols
er sSee tractor as ent for Owner
Lake
commission N.. {.lH oq 3 q | 3
Sworn to (or affi
this l{UUay of
rmed) and subscribed b
J ulv .2
Typq of"ldentifiW*cat n Produced Fl DL
Signatu
Name of person making statement
Personally Known
-
OR Produced ldentification f,f,x-
otary Public- State of Florida
STATE OF FLORIDA
COUNTY OF
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS FRONT
COUNTER
SUPERVISOR
REVIEW
P LANS
REVIEW
DATE
RECEIVED
SUPPLEMENTAL CONSTRUCTION LI EN LAW INFORMATION :
DESIG N ER/ENGIN EER:
Name: lret Ahhcv
_ Not Applicable
AddrgsS: 1rt47l Miramar parkwav 202
City:State: rr
zip:33027 Phone gs4-744-153a
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
City
zip:
State:
Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Namg: SBA To\rers LLC
Address: 8osl conqress Avenue
City : Boca Raton
7ip:
BONDING COMPANY:
Name:
Address:
City
zip P ho ne:
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 Countv makes no reoresentation that is erantins a oermit will authorize the oermit holder to build the subiect structure
which is in conflict with anv doolicable Home Owiers Asiociation rules. bvlaws or and covenants that mav restrict 6r orohibit such
structure. Please consult with iour Home Owners Association and reviEw'your deed for any restridions uihich may apply.
ln 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
rm prove ents to your property A Notice of Commencement must be recorded in the public records of St
Lu cie ou and posted on the jobsite before the first inspection. lf you intend to obtain financing, consult
wit d or an attorne before commencin work or recordin ur Notice of Commencement.
EV
ASHLEY L. OAVIS
MYCoMMISSIoN
'
HH 082913
EXPIRES: January 20, 2025
(signature of
ZON ING
REVIEW
DATE
COMPLETED
Phone: ser- zze-gzez
X Not App lica ble