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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO QMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:o� SCP+BYN ED Permit Number: St Lucie County I RECEIVED Building Permit Application APR 3 n 9niR Planning and Development Services Building and Code Regulation Division ST. Lucle County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMIT APPLICATION FOR: Electrical I PROPOSED IMPROVEMENT'LOCATION:1 I Address: 9650 S. Ocean Drive. Jensen n R each, FT. 34957 Legal Description: See attached Property ICJ Card Property Tax ID #: - -0 L-11k 2 LQIr) 0000 - © ()(r)- io Lot No. Site Plan Name: Hutchinson Island I Block No. Project Name: Sprint M173XCO37 I Setbacks Front Back: Right Side: Left Side: I DETAILED DESCRIPTION OF WORK: Upgrades to existing Sprint Telecommunications facility adding three (3) antennas and three (3) RRU's with associated jumpers and cables. 1 CONSTRUCTION INFORMATION:_f itiona wor o e e orme under this permit— c ec a apply: aHVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors Electric Plumbing Sprinklers Generator Roof �_ " Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ 15,000 S Ft. of First Floor: _ Utilities:11 Sewer ElSeptic Building Height: OWNER/LESSEE:' CONTRACTOR: Name Princess Condo ; Name: Benjamin Ekey Address: 9650 S. Ocean Drive Company: Atlantic Tower Services (ATS) City: Jensen Beach State: FL Address: 450 S. Ronald Reagan Blvd. Zip Code: 34957 Fax: City: Longwood State: FL Phone No. Zip Code: 32750 Fax: E-Mail: Phone No. 407-423-9071 Fill in fee simple Title Holder on next page (if different E-Mail: cliIlyRaccessats.com from the Owner listed above) State or County License: SCC131150970 IIIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. �I SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION: DESIGNER/ENGINEER: _ Not Applicable) MORTGAGE COMPANY: _ Not Applicable Name: Dewberry Engineers Inc.- Julie Andrews ' Name: Address: 800 North Magnolia Aveiniie Siflt4 J000 Address: City: Orlando State: 14L City: State: Zip: 32803 Phone321-354-9724 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: I Address: City: i City: Zip: Phone: Zip: Phone: I 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. Lucie County makes no representation that is gr which is in conflict with any applicable Home Own( structure. Please consult with your +Home Owners i In consideration of the granting of this requested p in accordance with the approved plans, the Florida a permit will authorize the permit holder to build the subject structure Iclation rules, bylaws or and covenants that may restrict or prohibit such Jon and review your deed for any restrictions which may apply. I do hereby agree that I will, in all respects, perform the work ng Codes and St. Lucie County Amendments. The following building permit applications are exempt*om 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 your paying twice for improvements to your property. A Notice of. Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencine work or recordine vour Noticelof Commencement iA/l Signature of Owner/ Lessee/Contractor as Agent fo er Signature o ontractor/Licen older i STATE OF FLORIDA I STATteMOIRIDA COUNTY OF I COUNTY OF urnml _ The forgoing instrument was acknowledged before me The forgoing instruRent was acknowledged before me this day of 20_ by this � day of H D n 20—IZ by Name of person making statement Personally -Known OR Produced Identification Name of person making tatement Personally Known 0 OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida) (tigy6(uro of Nota Pu tate f I Commission No. (Seal) ��1 P N ry Public State of F Commission No. �xl�I�eica N Ruiz g My Commission GG 156 y Expires 10/30/2021 OF 000 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED be DATE COMPLETED Rev. 8/2/17 i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -Date: Permit Number: SCANNED . BY • St Lucie Ocsanfy 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) 4624578 . Commercial X Residential PERMIT APPLICATION FOR: .Electrical PROPOSED. IMPROVEMENT LOCATION: Address: 9M0 S Ocean Dijv6..Jensen Beach Elf, 34957 -' Legal Description: See attached Property ID Card Property Tax ID #: 4502-610=0091=000-0 4Lot No. Site Plan Name: Hutchinson Island. Block No.' Project Name: Sprint MI73XC037. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: upgrades to. existing Sprint Telecommunications .facility adding, three (3). antennas and three (3) RRU's with associated jumpers -and cables. I CONSTRUCTtON,tNFORMATiON: - - - - itiona work to bjepertormea- mriaermis permit-cneLK an dNVly. CIHVAC :. LJ Gas Tank . Gas: Piping _ Shutters Electric Plumbing. O Sprinklers Generator Total Sq. Ft. of Construction: -Sq. Ft. of First Floor: _ Cost of Construction: $ 45,000 EJ utilities: Sewer septic QWindows/Doors 0 Roof Roof pitch Building -Height: OWNER/LESSEE: CONTRACTOR: Name Princess'Condo Name: Beniamin.Ekey. .Address:. 91650 S. Ocean Drive company: Atlantic Tower Senrices FATS) city: TensenBeach State: FL Address: asn S. Ro, ald Reagan Blyd. 34957 Fax: City: I ond State: FLoo Zip Code �- Phone No. fJ Zip Code: 2M Fax: E-Mail: Phone No.. 407-423-9071 Fill. in -fed simple Title Holder on next page'(if different . E-mail: ditAiccessats.com from the Owner listed above) State'or County License: SCC131150970: If value of construction is $2500.or. more; a RECORDED Notice of Commencement It required. i SUPPLEMENTAL.CONSTRUCTION-LIEN ,tAWIINFORIVIATION: SUPPLEMENTAL.CONSTRUCTION-LIEN ,tAWIINFORIVIATION: DESIGNER/ENGINEER:. _ Not Applicable ; MORTGAGE COMPANY: _ Not Applicable Name: DewberrjEngineers'Inc, Julie Andrews 1 Name: Address: R00 North dngnnlia A.venu s ,itP i onn� Address: City: Orkndo Stat City: State: Zip: 32803 Phone32t:3s4-9724 Zip: -Phone: .FEE SIMPLE TITLE-NOLDER: _-Not Applicable BONDING. COMPANY: Not Applicable Name: Name: Address: I Address: City:' City Zip: Phone• Zip: Phone:- OWNER/'CON_ TRACTOR AFFIDVIT: Application is hereby made to obtain a permit to cio the wont ano instaitalaon as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. .St..Lucie Counttyy makes: no representation that is granting a�permit will authorize the permit holder to build the subject structure which is in conflict twith-any applicable Home.Owners Association. rules, bylaws or and. covenants that may restrict or prohibit such ns 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 1 screen -rooms and accessory uses to another non-residentiai use WARNING TO OWNER: Your feilure:to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement-mUst'be-recorded:and-posted.on the jobsite before the: first inspection. If you intend to obtain financing; consult with lenderor an attorney_before. coinmen ` or or recording o otce of Commencement: ,Signat of wner/ Lessee/Contractoras Agent for Owner Signature o ontractor/Lice Ider . STATE 'OF FLORI STAT O IDA COUNTY OF COUNTY OF . rrini^i The forgoing instrum nt was acknowledged before me The -forgoing instru ent was acknowledged before me this!^. day of -J w � .20� by. this _Zday of_ r p p .20_1Z by, i'il%1(N n Name of person making statement Name of -person makin tatement Personally Known Y, R:Produced identification. PersonaNy Known _ OR Produced Identi%cation Type of Identification. Type.of Identification Produced Produced (Signature of Not Public- State of Florida (5igp'afur of NC Commission Now 13 pry:";., D.ERICKSON Commission No. MY COMM1sSlON Y FF 136H41 a EXPIRES:October3l, 2018 'rtR:` Bonded Thru Notary Publb Undenvdters . REVIEWS DATE_. .COMPLETI Rev.8/2/17 FRONT.ZONING:' SUPERVISOR COUNTER- REVIEW REVIEW PLANS I VEGETATION REVIEW REVIEW N ry Public state of FI ap a Prue N Ruiz My Commission GG 15E q o► Expues 10130l2021 SEA TURTLE' I: MANGROVE. REVIEW REVIEW' '