HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- M.Q642
Verizon PCS
ALL APPLICABLE INFO MUST BE COMPLETED FO�pRt,IC gr TO BE ACCEPTED
Date: Q I JliF�BNYIVtU Permit Number:
i St. Lucie County REG E Rf, FE
Building Permit Application MAR 0 9 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pluce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III
16800 OKEECHOBEE RD
Legal Description:
Property Tax ID N: 3201-244-0039-000-8
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
upgrade equipment at existing cell site
Lot No.
Block No.
iCONSTRUCTIONuINF0RMATIONC
I Iona wor to e. a orme under this perm —check a apply:
1:1 ri Gas Tank Gas Piping n_ Shutters :❑ Windows/Doors
Electric El Plumbing [:]Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sol Ft. of First Floor:
Cost of Construction: $ 14,000 Utilities: L]Sewer ElSeptic Building. Height:
OO VUNER%LESSEE:'. 'J "'
ICONTRAGTOR:
Name Verizon / Crown Castle
Name: Alan P Zirkelbach
Address: Q420 Congress Ave., #2000
Company: Ascend Wireless Networks, Inc.
City: Boca Raton State; FL
Zip Code: 33487 Fax:
Phone No.
Address: 756 Business Park Blvd. Ste103 _
City: Winter Garden State: FL
Zip Code: 34787T_—_ _ Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mall:
State or County License: CGC1521965
If value of constructionIs $2500or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTALCQNSTRUCTI0N LIEN. LAW. INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone:
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Evans Properties Inc
BONDING COMPANY:
Name:
= Not Applicable
Address: 660 Beachland Blvd Ste 301
Address:
City: Vero Beach FL
City:
_
Zip: 32963 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 attorney before
s
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF P"' L`- �C. �— COUNTY OF /n a,-v
Theoing instrum nitwas ledgq"efore me
foFg
this _ day of 201 by
C- t Nk s f+-Yt t C
Personally
Type of Idi
Commission No.
Revised 07/15/2014
NotaryPublic - State of Florida
COMIAglod # FF 915138
My Comm. Expires Sep 1, 2019
The forgoing instrume'�nt was acknowledged before me
this
�'dayof r✓'e%L!Lc� 20 /7 by
of
Commission.
Public- State of Florida
V'OR Produced Identification
Lacey N Stovall
Expires 04/18/2018
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