HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ---------Permit Number: ---------
Building Permit Application Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial -----
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Residential ------
Lot No .. ___ _
Block No. 28/35S/40E
Address: 1578 Digiorgio Road, Ft. Pierce, FLProperty Tax ID #: 2428-133-0001-0006Site Plan Name: Pl Fort Pierce
Project Name: ------------------------
I DETAILED DESCRIPTION OF WORK:
· a a ,on° proposed antennas on ex1st1ng tower,installat,on of (2) proposed equipment cabinets, installation of (1) proposed PPC, Installation of (1) Constructing a new wireless installation· Inst II f f (6) · · · ·
, opo wor 19 , 1nsta at,on a (6) proporsed RRUS, installation of (1) proposed fiber cabinet, installation of (2) proposed trunk cables proposed GPS antenna installation of (1) pr sed k r ht · II ·
New Electrical Meter ____ Second Electrical Meter ______ (Affidavit required)
I CONSTRUCTION INFORMATION:
Additional work to be performed under this per mit -check all th at apply:
Shutters _ Windows/Doors Pond _Mechanical
"-Electric
Gas Tank
_Plumbing
_Gas Piping
_ Sprinklers Gener ator Roof ____ Pitch
Total Sq. Ft of Construction: _______ _ Sq. Ft. of First Floor: __________ _
Cost of Construction:$ ________ _
OWN ER/LESSEE:. ... � .
Utilities: _ Sewer _ Septic Building Height: ___ _
. CONTRACTOR:
Name Silver Line Plastics Corp Name: Dan Ault
Address: OO0RiversideDr Company: Olin Wayne Companies Inc
City: _A_sh_ev_i11e ___________ State:� Address: 3060 ORANGE GROVE TRAIL
Zip Code: ___:.:2aa::::o:..:.4----Fa x:_________ City: NAPLES State: FL
Phone No. Zip Code: 341 20 Fax: _______ _
E-Mail: Phone No 239-776-5884
E-Mail DANAULT@OLINWAYNECOMPANIES.COFill in fee simple Title Holder on next page ( if different
from the Owner listed above)State or County License....!::C�G�C:::!...,!.1 ::=::52�2=-1.!.-"7:....::3�------
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.
1578 Digiorgio Road Ft. Pierce, FL 34982
34982
A2P0226A
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DESIGNER/E~GINEER: _ Not Applicable MORTGAGE COMPANY: N~t A" ·ji~~b-l~· · , · Name: APX Eng,neerlng Group Name: -pp
Address: 14471 Miramar Parkwal Address: City: Miramar State:£!:__ City: State: Zip: 33027 Phone 954-744-1538 Zip: Phone: -
FEE SIMPLE TlnE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: 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. ~lide Count(i makes no representation that ls granting a faermit will authorize the germit holder to build the subject structure which ls In con llct with anX applicable Home Owners Assoc atlon rules, bylaws or an covenants that may restrict or prohibit such structure . Please consult w th your Home Owners Association and review your deed for any restrictions which may apply.·
In consideration of the granting of th.is requested permit, I do hereby agree that t 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 str_uctures, swimming pools~ fences; walls, signs, s~reen 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 commencing work or recordin.R vour Notice of Commencement . . ~&ke · .. ·· '
..
Signature of Owner/ Lessee/Contractor as ~ent for Owner
STATE OF FLOR~. .
COUNTY OF . ' \ cwn \ -~d--e
Swo~or affirm~ a0iubscrlbed befo\e me of this day of O , 20.11 by
_·_Physical Presence or K, Online Notarization
:kl lJrtLJ. .
Name of person making statement.
Personally Known~ OR Produced Identification
Type of ldentiflcat on Produced
()v,M~M (W )
{Signa j uralof Notary Public-State of Florida) - ---
Commission No. Oo<33S) -(S eal) --. (' ---1 Motl,Y Public • Stitt d florlda I . m Commission' HH 06135k. •
i My comm. [xplr11 Otc 1, 2 ' • -··"eondtd t~ MatloMI llctllY """·
REVIEWS FRONT ZONING SUPERVISOR PLANS . VEGE TATION SEA TURTLE MANGROVE
COUNTER REVIEW REV IEW R.EVIEW REVIEW REV IEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
~ev 5/20/Ll