HomeMy WebLinkAboutBUILDING PERMIT APPLICATION870159 TMO L600 A2P003613
All IPPLICABLE.INFQ`MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SCANNED
'COUNTYBY
St Lucie County RECEIVED
_r.__ D A. Building Permit Application JUN 0 2 2021
Planning and Development Services
Builiiing and :Code -Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
PhdIne: (772) 462-15S3 Fax: (772) 462-1578 Commercial: X Residential
Address: 1100 Dyer Road
Property Tax ID #: 34-14-501-0713-2506 Lot No.
Site Plan Name: Block No.
Project Name: EXCALIBUR:PROJECTA2P0036B-8701'59
UPGRADE EXISTING EQUIPMENT TO TELECOM SITE Fog Gr fi atn
GuC�2! � e CeSSo a 13� ;N h� 1 i .. ,� �i-t - 1 v t2 Gn
w C-fS Sh p a< Comae C 14 -7 > 0 23 &C 7
t.
Additional work to be performed under this permit —check all.that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
X Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 12,000 Utilitie
Name Crgwn Castle
Address: 6420 Congress Ave: Suite 2000
City: Boca Raton State: FL
Zip Code: 33487 Fax: —
Phone No. 786-901=0118
E-Mail:isflpeffnft.s@crowneastle.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
f value of construction is $2500 or more, a RECORDED Notice
_ Generator _ Roof Pitch
Sq. Ft, of first Floor
s: _Sewer _Septic Building Height:
company.- Ericsson, Inc
Address: 6300 Legacy Drive
City: Plano State; Tx
Zip Code: 75024 Fax:
Phone No 352-446-1241
E-Mail steve.nichols@edcsson.com
State or County License CGC1518237
It value of HVAC Is $7,500 or more, a REC R.DED Notice of Commencement is required,.
v' 'AN (� �
_WornnF. ?P.vY►I`�' 10� ,�G��,
SllPPL�IVI�ENT L C®NSTRU LON �Nli
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain.a permit to do the work and: nstallation:as indicated;.
I Cer tlfy that no Work, of installation has.Commenced prior to the ,Nsuance of a permit:
St. Lucie Counttyy makes no representation that is granting a perinitwill-authorize the permit_holder to build the subject structure
which :is in conflict with any applicable Home:Owners,Association rules, bylaws or acid covenants that may restrict or:prohibit such
structure. Please consult with your.Hornw0wiiers Association and review your deed..for ariyresteictions which may apply:
In consideration ofthe of this requested permit; I do hereby agree that] will, in all respects, perform -the work
in accordance,with the -approved plans, the Florida Building Codes and St Lucie CountyArioendin ts'.
The following building: permit applications'are exempt from undergoing arfull concurrencyreview: room additions,
accessory structures, swimming pools, fences, walls,:signs, screemroorns and accessory u5es:to another non. -residential use
"WARNING TO OWNER: YOURFAILURETO, RECORD A NOTICE qF' COMMENCEMENT MAY RESULT IN: YOUR PAYING '
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.. A, NOTICE OF :COMMENCEMENT MUST. BE RECORDED AND,
POSTED ON THE JOB; SITE BEFORE THE .FIRST _INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
ITH' YOUR'LENDE RAN ATTORNEY`BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
eva
i
®R�IUTAT•I®IV:
:DESIGNER/ENGI•NEER;
_ Not,Applicable
MORTGAGE COMPANY:
Not Applicable
Name:.
Name:
Address:
Address:
City: _
State;
Clty_
State:
Zi�: Phone..
_
Zip: Rhone:
FEE SIMPLE TITLE HOLDER:.
Not Applicable
BONDING COMPANY:.
_Not Applicable
Name: clonal $isnatseryioes Ll:c
Name:
Address; 4017WashingtonRd
Address.
clay: McMurray. PA
-
Crtyc
.Zip; Phone:
r
• 1ss1r .:Phone::..
Zlp:
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature.of contractor/License:Holder
ST%�TE'OF FLO(�IDA
STATE OFFLORIDA
COUNTY OF �i�A ,(�
COUNTY OF' seminole
The.forgoing instrument was edged before me
The forgoing nstrument•was acknowledged before, me
this day -of. }OAK , 20� by
this,. 22 day:of .March . 20 21 by
11a
Steve Nichols
Name of person making tatement:
Name of person making statement.
to of Florida
Personally Known .."��'k
Personally Known �. OR Produc"e."d Identification
Ad���`ication
Type of ldentificato a M Commission GG 121794
Y
Type of Identification
�F• Ires 1ol2al2ozl
Produc_ ed •;11 ' e
Produced
EVAN DAVID WDNG
���,g�+�,� rmyAeresumaDmm
L�ecou®a
L � �eanrzma
(Signature°of Notary Public- State of Florida )'
(Signature of Notary eublic=State.of Florida )
a 3m3�
Corhmission No: (Seal)
i
Commission No. (Seal
REVIEWS
FRONT .
ZONING
SUPEftVlSbft :
PLANS
VEGETATION
SEPiTURTLE
MANGROVE
� 'COUNTER`.
REVIEW
REVIEW
REVIEVII
;REVIEW
REVIEW
REVIEW
DATE
RECEIVED...
....... ...
-DATE
COMPLETED