HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA . '.
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: PermitNumber:
RECEI%'- D NOV 10 2016
Building Permit Application SICANNEU
Planning and Development Services BY
Building and Code Regulation Division St. Lucie Counh
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
I PERMIT APPLICATION FOR: Building I
1,PR-OP,�OSEEi.�IMP.B�0,VEMEN.T-iL�6CA,T,ION':""�,�,�:,,'
Address: 1401 Swain Road Fort Pierce, FL 34947
Legal Description: Swapping out and adding equipment at already existing wireless facility
Property Tax ID #: 2418-242-0001-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILE15, bESCR_IPTIO'N''_1'O ... K'W'0_ R K
Right Side: Left Side:
TMO will be replacing 3 FXFC RRU with 3 FHFB, and replacing 3 FRIG with 3 FRIJ.
Lot No.
Block No.
CONSTRUCTIOWINF911MATION:
Tdclitional work to be nertormed under this permit— chec a apply:
0 HVAC E]GasTank DGas Piping Shutters []Windows/Doors
Electric Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sc Ft of First Floor:
Cost of Construction: $ 9,000-00 utilities: n Sewer D Septic Building Height:
'OWNER
LESSEE-
CONTRACTOR:
Name T-Mobile South LLC
Name: Daniel Ault
Address: 1300 Concord Terrace Suite 200
Company: Glotel, Inc.
City: Sunrise State: FL
Zip Code: 33323 Fax:
Phone No. 954-514-8020
Address: 3060 Orange grove Trail
City: Naples State- FL
Zip Code: 34120 Fax:
Phone No. 239-776-5884
E-Mail: N/A
Fill in fee simple Title Holder on next page (if different
from the Oviner listed above)
E-Mail: ccastro@sbasite.com
State or County License: CGC1522761
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. ';LfA lii 15�
NSTRUCTIOWLIEN
"'u."WIN FORMA
TION:
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: MordsonHemMeld
Name: N/A
Address: Two South University Dfive Suite 245
Address: N/A
City: Plantation State: FL
City: NIA
State: NIA
Zip: 33324 Phone: 954-577-4656
Zip: n/A Phone:
N1A
FEE SIMPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY:
—Not Applicable
Name: Juan Mas and Carol Ajas
Name: NIA
Address: 258 SW Reynolds Avenue
Address: NIA
City: Portst.Lucie -
City: N/A
Zip: 34983 Phone: N1A
Zip: NIA Phone:
N/A
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conlylict 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 inspecqipn;�F you intend to obtain financing, consult with lender or an attorney before
commencina work orfe26rding vour Notice of Corrimprirprnprit
STATE
as Agent for Owner
6(1)"/-
The fTrpipg instrument wa6 ackpciwledgej�efore me
this d . ay - - , 20 1�by
ItI4
(Name of person
(Signature of Notary P blic- e of Florida
Personally Known E�!!
OR Produced Ide JAL
Type of Identification Produced
Commission No.
Revised-07/15/2014
STATE OF FLORIDA
COUINTYCIF
The f Tgoing instrument was ac nowledged before me
0 5�
this _ft-cTa_y of 20 by
A, . V
Ayw
(Name of person acknowledging
(Signature of Notary Yublic-_ State of Florida
nally Known _Le:�- �OR Produced I
of Identification Produced W1T21%%"'__
nission No.
. ��ffi � 2 0 _�t
41
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