HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1
ALL APPLICABL INFO MU BE CP P ED;FQR APPLICATION TO BE ACCEPTED
Date: " 1 I (� I SCANNED Permit Number: iQ or • (xnO�
BY
St. Lucie County RECEIVED
Building Permit Application APR i 1 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Alteration III
PROPOSED IMPROVEMENT LOCATION:
Address: 6189 North US Highway 1, Fort Pierce 34951
Legal Description: 6 34 40 FROM NW COR OF S 112 OF S 1/2 OF NE 1/4 OF SE 1/4 RUN E 370.23 FT MIL TO W R/W LI US 1,
TH S 18 DEG 21 MIN 34 SEC E 488.91 FT, TH W LY #TON BDRY LrrO W LI E 1/2 OF SE 1/4, TH N 462.3 FT M/L TO POBLESS TO SRD AS IN DBK 88-560, 562- (4.67 AC)
Property Tax ID #: 1406-413-0003-000-8
Site Plan Name: Verizon Wireless Site# 62713 SPAIN TOWER
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: ,
Lot No.
Block No.
At existing communication tower, remove/replace 6 antennas and associated coaxial cable. Also to
install sub -rack into existing communication cabinet.
ON INFORMATION:
LJ Gas Tank UGas Piping
0 Plumbing Sprinklers
Total Sq. Ft of Construction::
Cost of Construction: $ 12&0
Shutters Q Windows/Doors
Generator 1:1 Roof
S Ft. of First Floor:
Utilities:nSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Vedzon Wireless
Name:
Address:7701 Telecom Parkway
Company: J. r_, ^n .:c T.r
City: Tampa State:FIL
Zip Code: 33637 Fax:
Phone No.
Addr s: �O 4 ,,+� A._�
City:I RJ., Stater
Zip Code: 3&601 Fax:
PhoneNo. JrLI Figs Zn-%5
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-M'17ma l� �cro. ei.ncGrir�c.
1
CdM
State or Count— y L�eArls.44'2,111
II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. _ II
SC)3— z5 �1a�
SUPPLEMENTAL CONSTRUCTION, LIEN LAVV INFORMATIONt
a.0
DESIGNER/ENGINEER: _ Not Applicable
Name: dines Fennell/canrop Telecom
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 13067Teiewm Parkway
Address:
City: Tampa State: FL
Zip: 33637 Phone: 813s14-9880
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name: Frank Spain
BONDING COMPANY:
Name:
_Not Applicable
Address: P.0.13-1149
Address:
City: Hobe Sound, FL
City:
Zip: 33475 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 fir%�innspection. If ntend to obtain financing, consult wi h lender or an attorney before
ci commenn"ork or reca vour Notice of Commencement.
_ Signature of Owner/
STATE OF FLO RgA STATE OF FLQ�B�DA
COUNTY OF �c i COUNTY OF h4�... eacin
The forgoing instru en was acknowledgefore me
this�dayof 20 IT,
y
person
The forgoing instrument was acknowledged before me
this -31— day of McPrl 20 K by
,LI SiLl
(N me of person acknowledging)
( ignature o Notary Public- State of Florida) ( ig ture o Notary Publ' ate of Florida )
Personally Known / OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission Na. issi �Y MICHAELSABOL
;eCommissianpFF964896Fliq _CommissienkFF964896
�,; Tres a ruary
Revised 07/15/2014
. `?t P'' Bonded ThMTMYFaminsuranw800-385-70i9 ••%S"'or iCgP` Bonded Thm Tiny Fain lnsurana 800385-7019
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