HomeMy WebLinkAboutBuilding permit application ground work (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 28000 Okeechobee Road
Property TaxID q: 3111-122-0015-000-3
Site Plan Name:
Project Name: A2P0252S
DETAILED DESCRIPTION OF WORK:
Modify existing telecommunications equipment (A2P0252S) Ground/Cabinet Work
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
_Gas Tank
_Plumbing
Tot
al Sq. Ft of Construction:
Cost of Construction: $ 12,000.00
Lot No.
81ock No.
_Gas Piping _Shutters _ WindowsJDoors _Pond
_Sprinklers _Generator _Roof Pitch
Sq, Ft. of First Floor:
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.
EMNTAtei\(TR1�CT�af LLEN IOW 1NFS�t11/IRffQAf`
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY; x Not Applicable
Name:smw EnAiIkaM9
Name:
Address:
Address:
City: State:
City: State. _
_
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE FiOLOER: x Not Applicable
BONDING COMPANY: z Not Applicable
Name:
Name:
Address:
Address:
City:_
City:
Zip: Phone:4,
Zip; Phone:
OWNER/ CONTRACTOR AFFIDVITt 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, L4c a Count makes no represegqcation that is granting a ppermit Will authorize the permit holde to build the subject structure
which �s In onF�kt with an Ilcable Home Owners Associatlon rules, bylaws�r anp covenants tat may, reshtrictY rpprohibitpsuch
structure,Plleaseconsultwit our Home Owners Association and review our glee( or yrestrictions whit ma a .
tpV
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,
acts sory"structures, swimming pools, fences, wall, signs, screen rooms and accessory uses to another non•residentlal use
dIARWiOillR. Your f`vtltue to Record a Notice of Commencement may result In paying twice for
rded In thepublic records of St,
pendto obtain financing, consult
attorne before commencin work or r r n our Notice of Commencement,
Signature of ner/ Lessee/Contractor as Agent for Owner
Signa r of Contractor/License Holder
STATE OF FL I
STATE OF FLORIDA
COUNTY OF
COUNTY OF !SeMINe) f�
S vprn to (or affirmed) and subscribed before me of
S yorn to (or affirmed) and subscribed before me of
dW Prese ce r Online Notarization
V Physical Presence or Online Notarization
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this 8v day of 2020 by
this Z day of I&VA"l , 2024) by
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Name of person making sta men\\t\* ///
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