HomeMy WebLinkAboutATC 302893 Dish MIMIA00619A BP app signed 10-18-21,TC 302893 Dish MIMIA00619A Collocation
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
g`Uo LUE.QIE
0
Building Permit Application
Planning and Development Services �(
Building and Code Regulation Division Commercial „ Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: ATC 302893 Dish MIMIA00619A Collocation
PROPOSED IMPROVEMENT LOCATION:
Address: i os .junsnine F'IMry (I urnpike and Exit 152), Fort Pierce 34945
Property Tax ID #: 2326-111-0000-010-1 Lot No.
Site Plan Name: TPK Ft. Pierce Block No.
Project Name: ATC 302893 Dish MIMIA00619A Collocation 13718938
DETAILED DESQRIPTION OF WORK:
ATC 302893 Dish MIMIA00619A Collocation to existing cell tower including (3) Panel Antennas,
Sector Frames, Jumpers, RRUs, Hybrid a e, metal a orm, ce Bridge,
(1) PPr; Cahinet- [1)-Equipment rnhinPt� O Power r'nndidt, (1) TPlrn rnnduit� TPlrn Fihor Rnxr
(1) GPS Unit, (1) Fiber NID
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: $ 25,000 Utilities: _ Sewer _ Septic Building Height: 220'
OWN ER/LESSEE: CONTRACTOR:
Name_ nosh Wralpgg� I I C Name: _ Pavel Radko
Address:9601 South Meridian Rlvd Company: Advanced Communications Technology LLC
City: Englewood State: CO Address: 15188 Park of Commerce Blvd Suite 11
Zip Code: 80112 Fax: City: Jupiter State: FL
Phone No. E- Zip Code: 33478 Fax:
Mail: Phone No 443-676-4800
Fill in fee simple Title Holder on next page (if different E-Mail
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: Chad E Tuttle Name:
Address: 1717 S. Boulder Suite 300, Address:
City: Tulsa State: oK City:
State:
Zip: 74119 Phone (918)-597-4630
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable
BONDING COMPANY:
Name: _
Address:
City:
Zip: _
Phone:
Not Applicable
w"imu-ry wim i rw%. i ur% mrrmo V 1 I . 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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please 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 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 attornev before com encinp,work or recordin our Notice f C
0 ommencement..
Signature of 4�gssee/Contractor as Agent for Owner
STATE OF FLORIDAp�` n
COUNTY OF a
Sworn to (or affirm ) nd subscribed before me of Physical Presence or Online Notarization
this _(day of 20 Z( by
Name of person making statement.
Personally Known OR Pro ed Identifipation.�_
Type of Identification Produc L2.S
(Signature of N ary Public- Sta e o Florida)
Commission No. kA 14 045il(33 (Seal)
bc State or Florida
lsonslon
REEK
HH 059433
2/2024
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
PV
d.sh-
LETTER OF LIMITED AGENCY
9/13/2021
Dear Sir/Madam:
On March 12m 2021, DISH Wireless L.L.C. ("DISH") and American Towers LLC ("Contractor") entered
into a Strategic Colocation Agreement ("Agreement") effective as of March 121' 2021. The Agreement
provided, among other things, for Contractor to provide to DISH site acquisition services (including zoning
and permitting services) for certain ground space and tower space.
With the assistance of Contractor, DISH desires to install wireless communications equipment at
the Site as part of its deployment of a wireless network.
Accordingly, DISH hereby authorizes Contractor and contractors sub (Crafton Communications Inc.)
to act on DISH's behalf in connection with obtaining all applicable use and zoning approvals, permits,
consents, authorizations and other related documents from the applicable government authority ("Zoning
Authority") so as to allow DISH, through its contractors, to install its equipment at a Site (the "Purpose").
DISH hereby acknowledges that Contractor may present this Letter of Limited Agency to the
applicable Zoning Authority, after which Contractor may act on DISH's behalf to effectuate the Purpose.
Contractor may deal directly with the Zoning Authority on all matters pertaining to the Purpose.
The above rights shall be self -operative, and no further documentation shall be necessary to confer
said rights. This Letter of Limited Agency will remain in effect until rescinded in writing by DISH.
Authorized for: Brian Sullivan on behalf of the Miami Market (Dish Wireless)
AGREED
DISH WIRELESS L.L.C.
B:
Y
Name: Sidney G. "Jerry" Pollard
Title: Site Development Manager— Miami Market