HomeMy WebLinkAboutcorrected applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
S
Date:: 9/3/2021 Permit Number:
(
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
Address: 21715 Orange Avenue Fort Pierce FL 34945
Property Tax ID #: Parcel2208-311-0001-000-6 Lot No.
Site Plan Name:' Adams Ranch Block No.
Project Name: Adams Ranch
MEN
' REMOVE (3) ANTEL X7$864 ANTENNAS
•INSTALL (3) ERICSSON VZ"J ANTENNAOMMEMEMMMEEMM
S
bUN
• INSTALL (3) ERICSSON RRUS 4448 RRUS
• IN.SW(_(2 1%"' HYBRID CABLES y
New tiectrlcw .,, Second Electrical Meter (Affidavit required)
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: $ 14,000 Utilities: _Sewer _Septic Building Height:
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
City: Jupiter State: FL
Zip Code: 32667 Fax:
Phone No. 8138480270
Zip Code: 33478 Fax:
E-Mail: edanahy@tepgroup.net
Phone No 561-.F12-,y(31
Fill in fee simple Title Holder on next page ( if different
E-Mail edanahy@tepgroup.net
State or County License CGC1521987
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Narne- Jq ' NtxINEER ' ' _Mot Applicab lee MORT6AGECOMPANY. ^ Not Applicable
Name; J@rktny R W,opster ;.
Name;
Address ,Vs' �p Rd ` Address;
,City: Ralg�h ; 5td'Ee'. NC_ Cry: Z(p:2Taaa State:
'= PhaneaRsseissel ,' Zip: Phone:
FEE 419MILE'TIT'LE HOLDER! Not Applicable BONDING COMPANY., NotApplic
Address. aHt3sh0hable
Name:
Name pb:Rpx taws
Address°
CitWs Fn XPiE ce
City*
Zip, i99 Phone,'' p Phone:
OWNER{ CONTRACTOR AFFiDVIT: Applic4on is hereby made to obtain a Permit to do the work and installation as indicated.
I certify tha n¢wo{lc;ar installation has
commenced prior to the issuance of a permit
St, Lucie Gaun maces na representation thak is granting a ermit willaut oriae thA t5ermit hofd%to build the subjectsttructure
which is in o lidtw�#h any pplydabie Nome - wn rs Assd€ ation rutes byaws or and covenants t at may restrict
structure Pease lsoclation
COnWitwit,' your home Owners or praFtibit such
and review your deed for any restrictions which may apply..
In consideration of the granting Ofthis retid4ted'permit, I do hereby agreethat I will, in all respects, perform the work
in accordancewith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fallow rlgtsuilding Permft apptieations are Lxempt from undergoing a full concurrency review: room additions,
accessory,struciures,-Swimming p606 fences, wall$, signs, screen rooms and accessory uses to another, non-residential use
WAIiNfNG'TO OWNER-, You rfailure to Record a Notice of Commencement may result in paying turlca for
jmpr6Vernents to your property, A Notice of commencement
mugt be recorded in the public records of St,
Lucie County and posted on theiobsite before the first inspection, If you intend to obtain financing,
consult
with lerlderoran at o !ey before commencing work or recordib a ,�Noaiw of eamrtiencernent:,
���
i0
Signature of Owner/ lessee/Contractor as Agent -for Owner-
STATEOF,FLd4I0A yf, i4 2
COUNTY OF St, ucie:a
this_ dayofirma4li and subscribed beforePhysical Presence'6y� ,}rjotarization
thiS�dayo-fueptem�gr
_ 262'I 6 uu ,•
by
Y , u,�au,t�t ,
AM1�IniA� r�/'f{pmNlk
Name of PPMO 1 ma, ng ateMent.
PersonallyKnown, 6R`praduced Identification
Type of Id ntificatipn produced --
0�'---�
.
lgnature of Diary ubllc, State of Florida i
Commission No., (seal)
REVIEWS
rRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
SEA TURTLE
MANGROVE
DATE
REVIEW
REVIEW
REVIEW
RELEIVt D
DATE I'
COMPLETED
ev
;