HomeMy WebLinkAboutcorrected_ELE Application v.0_signedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
O
p 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: Modifications to existing Verizon Wireless cellular system
PROPOSED IMPROVEMENT LOCATION:2929 N 25th St, Ft. Pierce 34946
Address: 2929 N 25th St, Ft. Pierce 34946 - tower (Verizon Wireless Site# 118205)
Property Tax ID #: 1112-441-0001-000-9 Lot No
Site Plan Name:
Project Name: Verizon Wireless Site# 118205
I DETAILED DESCRIPTION OF WORK:
Block No.
At existing communication tower site, equipment pad, remove/replace communication cabinets. Also install non -electrical support device.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: I
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: $ 21,000
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Verizon Wireless - Lessee
Name: Pavel Redko
Address: 7701 Telecom Parkway
Company: Advanced Communications Technology
City: Tampa State: _
Address:15188 Park of Commerce Blvd, Suite 11
Zip Code: 33637 Fax:
City: Jupiter State: FL
Phone No. 410-952-3860 - Paul Bailey/Agent
Zip Code: 33478 Fax:
E-Mail:paul.bailey@caawireless.com
Phone No (561) 771-6677
Fill in fee simple Title Holder on next page (if different
E-Mail service@advancedcommtech.net
from the Owner listed above)
State or County License EC13007510
n value or construction is c-*w or more, a KtUJKuty MUM 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
Name: Hugh Ralf€y, P.E./C9VR Telecom Design
Address: 6505 Norsh HimesAvenne
City: Tamp& State: FL
Zip. 33614 Phone 770-853-1233
FEE SIMPLE TITLE HOLDER: Not Applicable
N a m e: Tr int Imp Trust Fund
Address: 3900 Commonwealth Blvd
City: Tallahassee, FL
Zip: 32399 Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
x Not Applicable
State:
BONDING COMPANY: x Not Applicable
Name:_
Address:
City:
Zip:
Phone:
vvvrr� nI n.+c.I' vn mrriuvr r : 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 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 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 attorney before commencin work or recording your No ' of Commencement.
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Signature of Owner/ Lessee/Contractor as'AgEFt for Owner !Sign
/License H
STATE OF FLORIDAP STATE OF FLOMtr>
COUNTY OF__ COUNTY OF cQy,n a
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
t is _0' day of.. 4624�- by
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Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
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REVIEWS FRONT
COUNTER
DATE
RECEIVED
Sworn to (or affirmed) and subscribed before me of
�(Phty ical Pre nce or Online Notarization
this day of 2r3 by
Name of person making statement.
Personally Known OR Produced Identific
Type of I Ification 1
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Produced
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Signaturet,of Notary Public- State of Florida)
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