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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 1to
Date: SCANNED Permit Number:
BY
--_ a ' DIM l lria County RECEIVED
Building Permit Application
Planning and Development Services MAR 0 9 2015
Building and Lade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERMITTING
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Reside$ttiaicle county, FL
PERMIT APPLICATION FOR: Other
' PROPOSED'IMPROVEMENT LOCATION, ; , ,
Address: 7370 South Ocean Drive, Jensen Beach, FL
Legal Description: Dune Walk by the Ocean a/k/a/ Sand Dollar North
Property Tax ID #: 3522-607-0000-0005
Site Plan Name: Dune Walk 68843
Project Name: Verizon Wireless AWS
Setbacks Front Back:
Right Side: LeftSide:
Adding one cabinet within existing compound
L JHVAC IJ Gas Tank
Electric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 9,000
perms— cnecKall apply:
In
Gas Piping _Shutters
Sprinklers E] Generator
S Ft. of First Floor: _
Utilities:ll Sewer 0 Septic
Lot No.
Block No.
❑ Windows/Doors
0 Roof
Building Height:
OWNER/LESSEE:
`CONTRACTOR.
Name Verizon Wireless
Name: VZM mean
Address:777 Yamato Road
Company: Ascend Wireless
City: Boca Raton State: FL
Zip Code: 33431 Fax:
Phone No.
Address: 1133 Crown Park Circle
City: Winter Garden State: FL
Zip Code: 34787 Fax:
Phone No. 407-451-0474
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: P,5n 1 1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
6
SUPPLEMENTALCONSTRUCTION-LIENLAIN=INFORMATION '` -k ..
DESIGNER/ENGINEER: _
Name: ForesileGr up
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Add ress: 10150 Highland Manor Drive, 8210
Address:
City: Tampa
Zip:33610 Phone:
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name: DunewalkbytheOman
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 7370 South Ocean Drive
Address:
City: Jensen Beach, FL
City:
Zip: 34e57 Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
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, 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 attokqey before
of Owner/ Lessee/Agent
STATE OF FLOW YSTATE OF FLORjD[a
COUNTY OF ��� COUNTY OF �gkt
The forgoing instrument was acknowledged before me
this Mday of P)D("Vw' 20 Eby
Public -State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission
o,,0 Pu Notary Public State of Florida
VIP —
o e M oom�asao aHFF 108131
Revised07/15/201 or EvIres0an8Ro18
The forgoing instrument was acknowledged before me
this ilrrday of Glr'A20 15 by
10lon %r 1W bac h
wwmau
gnature of N ary Pu lc- tate of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Lacey N Stovall
Expires 0�4118�018
of Florida
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