HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.
Permit Number-,
Building Permit Appl-a
ication
Planning and Devetopment Services
Building and Code Regulation Division
2300 Virgin to A venue, Fort Pierce FL 34982
Phone: (772) 4 -1 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: Antenna Tower
� PROPOSED IMPROVEMENT LOCATI-ON:
Address:. 1401 Swain Road Fort Pierce,, FL 34947
Property Tax ID #: 2418-242-0001-000-0
Site Plan Name.
Project Name:
DETAILED DESCRIPTION OF WORK:
Removin
and re lacin antennas and eguipm end at airead
New Electrical Meter Second Electrical Miter
CONSTRUCTION INFORMATION:
exsistin
Lot No.
Block Na.
T-mo 'i els wireiess facifitv.
(Affidavit required)
Additional work to
be performed under
this permit — check
all that apply
Mechanical
Gas Tank
Gas Piping
Shutters Windows Doors Pond
X Electric
Plumbing
�Sprinklers
Generator
Roof
Pitch
Total Sq. Ft of Construction: 5q. Ft. of First Floor:
Cast of Construction: $ 0 QQO Utilities; � Sewer � Septic Building Height: 450f
OWNER/LESSEE: CONTRACTOR:
Name T-Mobile South LLC Name: Steve Nichols
Address: 1300 Concord Terrace Suite 200 Company: Ericsson Inc.
City: Sunrise State: FI Address: 6300 Legagy Dr
Zip bode: 3332„�� Fax: NIA City: Plano Stake: Tx
Phone No. 561-226-9287 dip Cade: 5024 Faye:
E-Mail: _ m Pane No 3_52..446-1,241,
Fill in fee simple Tide Holder on next page ('14 different E-email steve-nichols@eriesson.com
from the Owner listed above) State or County LicenseCGC.1518237
If v l u e
Gf
construction is
2500 or more, a RECORDED Notice o �r rye n cement is required.
If value
of
HAVC is $7.,501Dr
more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X. Not Applicable
Name: Name:
Address: 4F
Address:
City: Micamar Stag:.. City: State:
Zip: 33027 Phone _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:.- Address:
City: Port St Lucie City:
Zip: 3493 ,,f�,Phone: 35r2.l.-226-928Z ,.�..,.. _ Zip: Phone;
OWN E R/ CO NTRACTOR AF F I DVIT,',' AppI icativn is hereby made to obtain a permit to da the work and insiallation as indicated.
I certify that na work or 1*nsta4iation hay commenced friar to the issuance of a permit.
St. Lucie County makes no representation that i granting it will authorize the permit holder to build thesubject tructu r
whichisi n con ll t ith a n app Iica I e H or a Owners A ocia to rules, bylaws or and covenants that a restrict or prop i hit such
tru cture. Please consult with you r H o rre Owners Association and review you r deed for any restridions wh ich may apply.
In consideration of the granting of this requested permit, f do hereby agree that l will, in all respects, perform the work
in accordancewith the approved plats* the Florida Building Codes and St. Lucie County Amendments.
The fallowing building permit applications are exempt from undergaing a'fuff concurrency review: roam additians,
accessory structures, swimming pools, fences, walks, signs, screen rooms and accessory uses to another non-residential use
WARNING T OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improve ents to your property. A Notice of Commencement must be recorded ire the public retards of St:,
CLuciety and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with I r or an attorney before commencing work or recording Vaur Notice of Commencement.
Signature
0wrier/ LesseejC c or gent for owner
STATE OAF FLORIDA
COUNTY OF 5 tV--5W;-oWW lftjo-�.We
Sworn to (or affirmed) and subscribed before me of
thisday of 0`Z.(by
Ir A I IN
Name of person making statement.
Personally Known 6 OR Produced Identification
T tt ati on Produced
J-S-rg'r,W1J�Kaflvtary P ulalic-St—a-t-b of Flarida )
Commission No. ��3� � � (Sea[)
C
REVI EU11S
DATE
RECEIVED
DATE
COMPLETED
ev 1
FRONT
COUNTER
zonriNG
REVIEW
SUPERVISOR
REVIEW
Physical Presence or Online Notarization
olry Public State of Florida
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MY commis" ln
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PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
EI EW
MANGROVE
REVIEW