HomeMy WebLinkAboutBuilding Permit App Ground workAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
IM
O �
° a Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1S53 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 12200 Angle Rd, Fort Pierce, FL 34945
Property Tax ID #: 1332-211-0002-000-5
Site Plan Name: ANGLE ROAD
Project Name: ANGLE ROAD
DETAILED DESCRIPTION OF WORK:
Ground Work: remove (1) cabinet, install (1) rack
*"ALL ANTENNA EQUIPMENT WILL BE STEALTH/NEUTRAL COLORS*"
New Electrical Meter Second Electrical Meter
Lot No. 4
Block No.
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing `Sprinklers —Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000.00
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name AMERICAN TOWER CORPORATION
Name: Pavel Redko
Address:10 PRESIDENTIAL WAY
Company: Advanced Communications Technology
City: WOBURN State: _
Address:15188 Park of Commerce Blvd, Suite 11
Zip Code: 01801 Fax:
City: Jupiter State: FL
Phone No. 916-385-4266
Zip Code: 33478 Fax:
E-Mail: mbaker@tepgroup.net
Phone No 561-512-3761
Fill in fee simple Title Holder on next page (if different
E-Mail kristee@advancedcommtech.net
from the Owner listed above)
State or County License CGC1521987
IT value Oi consxruc[lon is L,uu or more, a KtcUKUtU Notice of commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of commencement is required.
SUPPLEIV
ENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER
Name: ANC
Address: 42
City: RALEIG
Zip: 27601
ENGINEER: — Not Applicable
EW REID IRWIN
MORTGAGE COMPANY: x Not Applicable
Name:
FAYETTEVILLE ST, SUITE 600
Address:
City: State:
Zip: Phone:
State: Nc
Phone 916.385-4266
FEE SIMPL
Name:Indrlio
Address:46
City: VEROPEACH
Zip-. 32966
TITLE HOLDER: ` Not Applicable
loldingsLLC
BONDING COMPANY: x Not Applicable
Name:
Address:
69olhAve
City:
Phone:916.385-4266
Zip, Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that nq work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con ict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Plea a consult with your Home Owners Association and review your deed for any restrictions which may apply.
In considerat'io of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance Vith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following quilding permit applications are exempt from undergoing a full concurrency review: room additions,
accessory stru tures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING T3 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 Co my 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.
Signature o wrier/Le—Le/Contractor as Agent for Owner Signature of C tr a der
STATE OF F STATE OF FL
IDA
COUNTY p OR�Cow COUNTY OOF� 220,. AJ
Sworn to (or ffirmed) and subscribed before me of
X Physical Presence or Online Notarization
this2� cloyof SEeOL � ._2D2Tby
Name of pers n m'aking statement.
Personally Known X OR Produce titiatlon _
Type of Identi ication �.�\�( A /f—
Produced nTA/�� Q
Comm. Expires
ignature of Notary Public- State Of Flo4ft
No. G 342460 ,
Commission No. Cn &I_ 1"yt4_ ,v 0eal) . , ,',T
/'1.
0 "0:,
Sworn to (or affirmed) and subscribed before me of
Ph�yy�sical Pre n e or Online Notarization
this 2"i'► clay of 202Tby
f„ kzf
Name of person making statement.
Personally Known OR Produced identificationType of Icl,ication
Produced.
(Signature of Notary Public- State of
Commission No. 141405V47)3 (Seal)
REVIEWS FRNT CO ONTER I ROEV1 W...,,.I.,s REVIEWUPERVISOR � RPLANSEVIEW I VEGETATIEATURTANGRO
REV EWON I S REVIEWLE 1 M EV EWVE
RECEIVED