HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONa.ti -
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 3 �5 Permit Number:
RECE11.7D NOV 23 2015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division C1�
2300 Virginia Avenue, Fort Pierce FL 34982 SPANNED
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residentia By
PERMIT APPLICATION FOR: Building _ p}��'� j�
St. Lucie cotintv
PROPOSED IMPROVEMENT LOCATION:
Address: 1401 Swain Road Fort Pierce, FL 34947
Legal Description: 18 35 40 NW 1/4 OF SE 1/4 OF NW 1/4 AND E 40 FT OF SW 1/4 OF SE 1/4 OF NW 1/4-LESS S 44.5
Property Tax I D #Y: 2418-242-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name: TMO L700 MHz
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and/or replace antennas and equipment at already existing facility.
OHVAC UGas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 12,000.00
Piping ri Shutters ❑ Windows/Doors
nklers 11 Generator EIRoof
S Ft. of First Floor: _
Utilities:Cn Sewer El Septic
Building Height:
,OWNER/LESSEE:
CONTRACTOR:
Name T-Mobile South LLC
Name: Dan Ault
Address: 1300 Concord Terrace Suite 200
Company: Glotel, Inc
City: Sunrise State: FL
Zip Code: 33323 Fax: N/A
Phone No.954-514-8020
Address: 3060 Orange Grove Trail
City: Naples State: FL
Zip Code: 34120 Fax: N/A
Phone No. 239-776-5884
E-Mail: Denise.Correa6@T-Mobile.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: danault@olinwaynecompanies.com
State or County License: CGC1522761
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,SUPPLEMENTAL CONSTRUCTION LIEN LAW. INFORMATION,-
DESIGNER/ENGINEER: x NotApplicable MORTGAGE COMPANY: x Not Applicable
Name: CaltropTeleasm Name: N/A
Address:3400 Lakeside Drive Suite 525 Address: N/A
City: Miramar State: FL City: N/A State:
Zip: 33027 Phone: 954-874-7870 Zip: N/A Phone: NIA
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: x Not Applicable
Name: Juan Alas and Carol Alas Name: N/A
Address: 258 SW Reynolds Avenue Address: N/A
City: Port St. Lucie city:N/A
34983
Zip: Phone: N/A Zip: N/A Phone: N/A
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, 1 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
OVARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
i rovements to your property. A Notice of Commencement must be recorded and posted on the jobsite
be re the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com encine work or recordine vour Notice of Commencement n i
_ Signature
STATE OF FI
COUNTY OF
The foJtame instrument was acknowledged be bre me
this / day of N0V 204J—by
STATE OF FLORIDA
COUNTY OF
The forgoing instrumenty+as acknowledged boore me
this day of N OV 20 /1 by
(Name of person acknowledging) (Name of
State
Personally Known C/OR Produced
Type of Identification Produced
Commission No.Gq—'P')
Revised 07/15/2014
ire of Mary Public- St of Florida) ��tUllliU4r
ROD
Ily Known OR Produced `d23Lon.'__.
Identification Produced
sion No. 6CJPY3 7/ 7 _ff
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