HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.y
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `aA `' `�
Permit Number:
RECEWTH JUN 2 8 2016
SCANNED
Building Permit Application By
Planning and Development Services St. Lu�il?
LU
Co
Building and code Regulation Division lint,
2300 VirginioAvenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial xxx Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line U -Vk `� }
PROPOSED;IMPROVEMENT LOCATION:
Address: 6120 Glades Cut Off Road, Ft. Pierce, FL 34981
Legal Description: Longitude 80 degrees, 23' 21.35"W
Latitude 27 degrees, 22' 57.58" N
Property Tax ID #: 2335-441-000100017
Lot No.
Site Plan Name: Landfill
Block No.
Project Name: Landfill Retrofit - 300' Guyed Tower
Setbacks Front Back: Right Side: Left Side:
;
DETAILED DESCRIP,TION'OF WORK,
I
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r • `'
Reinforce tower legs at torque arm and install 2 PARE-59W microwave dishes.
CONSTRUCTION INFORMATIONc
,.I
Additional work to e e orme un erthispermit—c ec a aPP Y:
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OHVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
L—_) Electric 0
Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $40,000.00 Utilities:Sewer OSeptic Building Height: 300'
OWNER/LESSEE: PONT
NameSt. Lucie County
Name Gerald Kyle Ingram
Address:2300 Virginia Venue Company: Clifton Tower Service, Inc.
City: Ft. Pierce State: FL Address: 2800 S. Goldenrod Rd.
Zip Code: 34982 Fax: Orlando
Cirv' State: FL
772-462-1000
Phone No. Zip Code: 32822 Fax: 352-771-2016
E-Mail: Phone No. 407-947-94561407-277-4791
Fill in fee simple Title Holder on next page (if different E-Mail: kyle@cliftonstower.com
from the Owner listed above) State or County License: SCC131151646
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
X Not Applicable
X Not Applicable
St.
is inoconfliccttawith any applicableiHothat
e Owners Associate n rules,bylaws or the permit
covenants that that may restrict the estrict ojrprohibit 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 attorney before
commencinework orrprofrdinaximir..Fr
s
51grieture of Contracto17License Holder
STATE OXFLORIDA c
F_ der ��`� STATE OF FLORIDA
COUNTY O
COUNTY OF orenya
The forgoing instrument was acknowledged before me I The forgoing instrument wasacknowledged before me
this ,L day of IMIP-- 20 aby this 21 day of Jme 20 ((o by
(Name of person acknowledg ) I'
ignature of Notary Public- State of Nor' a
Personally Known— OR Produced Id ification
Type of Identification Produced
Commission No.
Revised 07/15/2014
Commisp atFF924875
Expires October 6, 2019
W. H. Mnaitl
(Name
�ofperson acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known XXXX OR Produced Identification
Type of Identification Produced
Commission No. EE206526 c
of Fi i
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