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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 9-21-21STRAZULLA - ATC 5120 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 09/21/2021 Permit Number: . �.. Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial V Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 13698 Indrio Road, Fort Pierce, FL 34945 PropertyTax ID #: 1201-111-0002-000-5 Lot No. Site Plan Name: STRAZULLA Block No. Project Name: ATC FL - STRAZULLA DETAILED DESCRIPTION OF WORK: WIRELESS ANTENNA UPGRADE & GENERATOR SWAP AT EXISTING CELL TOWER SITE New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: (Affidavit required) Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors Pond V Electric _ Plumbing _ Sprinklers V Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 20,000 Utilities: Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name AMERICAN TOWER CORPORATION Name: Pavel Redko Address: 10 PRESIDENTIAL WAY Company: COMMUNICATIONS TECHNOLOGY INC City: WOBURN State: MA Zip Code: 01801 Fax: Phone No. 815-409-5242 E- _ADVANCED Address: 15188 Park of Commerce Blvd, Suite 11 City: Jupiter State: FL Zip Code: 33478 _ Fax: Phone No 561-771-6677 Mall: apaul@tepgroup.net Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-mail kristee@advancedcommtech.net / apaul@tepgroup.net 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. SUPPLE �NTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNED/ Name: Address: City: Zip: NGINEER: _ Not Applicable MORTGAGE COMPANY: V Not Applicable Name: Address: State: Phone City: State: Zip: Phone: FEE SIMPLE Name: Ind6o Land Address: 79CO City: Boca Ra Zip: 33434 TITLE HOLDER: _ Not Applicable Holdings LLC BONDING COMPANY: Not Applicable Name: Glades RD Ste 402 Address: on City: Phone: 815-409-5242 Zip: Phone: OWNER/ C( TRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that nb ork 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 conflicts ith any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Pleas consult with your Homeowners 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 W th 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 strutt res, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING T OWNER: Your failure to Record a Notice of Commencement may result in paying twice for improve ents 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 lenclE r or an attorney before commencing work or recording vour Notice of Commencement. Paz ner/ L sse /Contractor as Agent for Owner Signature of STATE OF FL RIDA COUNTY OF. Broward Sworn to (or of firmed) and subscribed before me of X Physical Presence or Online Notarization this 21st day ol September 2021 by Name of parsor making statement. X "1 Personally KnQ n OR Produced Identification o` Type of I ntifi ation Produced , �`` 'N �T9zd (Signature of N tary Public- State of Florida) GG342g60 �� Commission Nlo. GG342460 (Seal) Seal 4 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5120/21