HomeMy WebLinkAboutBuilding permit application Tower work UPDATEDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
�J
O
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial XX Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 28000 Okeechobee Road
Property Tax ID #: 3111-122-0015-000-3
Site Plan Name:
Project Name: A2P0252S
DETAILED DESCRIPTION OF WORK:
Modify existing telecommunications equipment (A2P0252S) Tower Work
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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: $ 12,000.00
_Generator
Lot No.
Block No.
_Windows/Doors _Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Adams Ranch Inc
Name:Steve Nichols
Address: PO Box 12909
Company: Ericsson, Inc
City: Ft Pierce State: _
Zip Code: 34979 Fax:
Phone No.954-444-2822
Address:6300 Legacy Drive
City: Plano State: TX
Zip Code: 75024 Fax:
Phone No954-444-2822
E-Mail: bart.simon@towerquest.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailsteve.nichols@ericsson.com
State or County License CGC1 518237
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.
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DESIGNER/ENGINEER:
Not Applicable
MORTGAGE
COMPANY;
x Not Applicable
Name:sraw engmaanng
Name;
Address;
Address:
City;
State; _
City;
Statel
Zip; Phone
Zip:
Phone:
FEE SIMPLE TITLE MOL4ER:
x Nat Applicable
BONDING COMPANY:
x .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 worker Installation has commenced prior to the Issuance of a permit,
which is C u ntvim wit an a represeggqqtation that is granting a ermit W111 outhhorize the ermit holder to build the subject structure
n h $ppiicaple Home Owners AssocPatlon rules, bylaws�r a�t covenants that may restrict or prohibit such
structure. Please consult w t r your tR+ome Owners Assoclatlon and review your ee c r 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,
Th following building permit applications are exempt from undergoing a full concurrency review; room additions,
acce sory structures, swimming pools, fences, wally, signs, screen rooms and accessory uses to another non•residentlal use
MAW 5'O Ok °ER' Your i'44lure to Record a Notice of Commencement may result In paying twice for
m i roveents to your property, A Notice of Commencement must be recorded In the public records of SG
l u e County and posted on the Jobsite before the first InspecAon.. if you Intend to obtain financing, consult
as
STATE OF Ft
COUNTY OF
S�vprn to (or affirmed) and subscribed before me of
dW. Physical Prese ce r,�____Online Notarizatlon
this day of 2020 by
Name of person making ss {*yg�q�
Y p51tT7b;�`F loon Personal) Known 0 r istlR aflons
Type of Identill adt n ; o�`�8E ?02� '•
Produc
STATE OF FLORIDA
COUNTY OF �.EMjAjo(.�
S m to for affirmed) and subscribed before me of
Physical Presence or � Online Notarizatlon
this Z day of &VOfG? 2020 by M
Name of person making statement.
Personally Known OR Produced
e of Identification
Typ
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(Signature of Votary Pu is 3 a�oF��oNpaiBd �a :�' Q'� (SI nature of Notary Puglic-State of Florida i �.r
Commission P q�i//o�R P Fubnc jP��p; NZ;
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