HomeMy WebLinkAbout118197_Greene Property_GAS Application v.0_signedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SM' [LU, C UL61-l",
V iti Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Modifications to existing tower cellular system
PROPOSED `IMPROVEMENT LOCATION.31t0N.USHighwayAtA--tower
Address: 25500 Minute Maid Rd., Ft. Pearce 34945 - tower (Verizon Wireless Site# 118197)
Property Tax ID #. 1112-441-0001-000-9
Site Plan Name:
Project Name: Verizon Wireless Site# 118197
DETAILED DESCRIPTION OF WORK
At existing cellular site equipment platform, removelreplace generator.
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 35,000
_ Generator
Sq. Ft. of First Floor:
Lot No._
Block No.
Windows/Doors _ Pond
_ Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Verizon Wireless- Lessee
Name:
+
o 1
Address: 7701 Telecom Parkway
Company: I Y$
City: Tampa State:_
Zip Code: 33637 Fax:
Phone No. 410-952-3860 - Paul Bailey/Agent
E-Mail: paul.bailey@caawireless.com
Address:t Q Iq
City: Rul- o,- ('� State: �L
Zip Code: �� F/la�^x:
Phone No '�`!'JrI "tl/�
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail'h 1��C�fljLtCCL'YV1 ( P q'[ 3 &
State or County License_ �-.j �QS�
IT value or construction is L!)W or more, a KLLUKULU 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
N acne: HuM Ray. fIX. i MRTeleGom Deslp
Address: 6575 Nu m Hhes Avenue
City: Tampa State: Pc
Zip: 43Hla Phone rya-053-123a
FEE SIMPLE TITLE HOLDER. Not Applicable
Na me: Greene Groves ana Ranch Do.
Address. 2-75 says Ave.
city: Vero Beach, FL
Zip: 32960 Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Andress.
City:_
Zip:
Phone:
x Not Applicable
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 witI 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 t will, In ail respects, perform the work
in accordance with the approved playas, 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 lenderp&an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee'/Contract❑r as AgQ,/itfor Owner
STATE OF FLORIDA
COUNTY OF P404
C1
S to (or affirmed) and subscribed before me of
Phvical Pres nce or Online Notarization
this day of �u�-r. __— _---, 2020 by
l At.L 94'.& C-1
Name of person making statement.
Personally Known -OR Produced Identification
Type of identification
Produced
[Signature of Wiary Public
" CLAi1HT h1AR4E SAHOf.
Commission NQ. i -
`?"ny-Cort(GGi962ii1
` , Expires May 14, 2022
rrc�Fa'nhSinnea80039*r74t8
gnatur ntractorJLicense Holder
STATE OF FLO I A
COUNTY OF
Sw to (or affirmed) and subscribed before me of
PP Physical Pres nce r Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known J_ OR Produced Identification
Type of Identification
Produced
4V hnn a assmom
a 0 J
(signature bl3kat�3t@9l�?fiPIbrida )
x Comm# RH124010
Commission is i Exoires4/28I2025(Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REV]EW
DATE
_._.. _.._
RECEIVED
DATE
COMPLETE ❑
Ev,