HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/3/2021 Permit Number:
LF � 61,5,
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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:Wireless Antenna Upgrade on an Existing Cell Tower
PROPOSED IMPROVEMENT LOCATION:
Address: 6189 North US 1 Fort Pierce FL 34951
Property Tax ID#: Parcel 1406-413-0003-000-8 Lot No.
Site Plan Name: SPAIN TOWER Block No.
Project Name: SPAIN_TOWER
DETAILED DESCRIPTION OF WORK:
Wireless Antenna Upgrade and Equipment Swap on Existing Cell Tower (Please See Site Plans)
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors Pond
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 15,000 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Verizon Wireless Name: Pavel Redko
Address:4700 EXCHANGE CT Company:ADVANCED COMMUNICATIONS TECHNOLOGY IN
City: BOCA RATON State: FL Address: 15188 Park of Commerce Blvd, Suite 11
Zip Code: 32667 Fax: _ City: Jupiter State: FL
Phone No. 8138480270 Zip Code: 33478 Fax:
E-Mail: edanahy@tepgroup.net Phone No 561-512-3761
Fill in fee simple Title Holder on next page ( if different E-Mail edanahy@tepgroup.net —
from the Owner listed above) State or County License CGC1521987
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Jeremy K Wooster Name:
Address:326 Tryon Rd Address:
City: Raleigh State: NC City: State:
Zip: 27603 Phone 9196616351 Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^Not Applicable BONDING COMPANY: _Not Applicable
Name: Mary Jane Spain(TR) Name:
Address: PO Box 1149 Address:
City:Hobe Sound City:
Zip: 33475 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
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 inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
u K n;_X4
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF St. Lucie
Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization
this 0,'3 day of September 2o21 by
o .
Name of person making statement.
Personally Known Y OR Produced Identification
Type of Identification Produced .�AIIL�rO ,,"'°°*°
No71
i
(Signature of Notary Public-State of Florida ) ��co"�ih �•��
62�kAireS
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5120121