HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: �-A M Permit Number: U ' al
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Building Permit Application SCANNEL)
Planning and Development Services BY
St. Luce Count
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 Ill
Address: 7370 South Ocean Dr., Jensen Beach 34957 (Verizon Wireless Site# 68843)
Legal Description: Map ID#: 35 / 21 N
Sec/Twp/Range: 22/36S/41 E
Property Tax ID #: 3522-607-0000-000-5 Lot No.
Site Plan Name:
Project Name: Verizon Wireless Site# 68843 DUNE WALK
115n, 71
Setbacks Front Back: Right Side: Left Side: II
DETAILED DESCRIPTION OF WORK:
At existing communication site, modification of 6 existing antennas reusing associated coaxial cable.
Also to install 6 BIAS-T units at antennas and install 6 diplexers and 6 triplexers at platform.
CONSTRUCTION INFORMATION:
itiona wor to ��e p.e,I orme under t—checkispermit a apply:
VAC IJ []HGas Tank Gas Piping _ Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 21,000
S Ft. of First Floor: _
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Verizon Wireless
Name: Alan Zirkelbach
Address:7701 Telecom Parkway
Company: Ascend Wireless Networks, Inc.
City: Tampa State: FL
Zip Code: 33637 Fax:
Phone No.
Address: 756 Business Park Blvd., Suite 103
City: Winter Garden State: FL
Zip Code: 34787 Fax:
Phone No. 407-451-0474
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: veronica.carmean@ascendwirelessnetworks.com
State or County License: CGC1521965
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW, INFORMATION:
k
DESIGNER/ENGINEER: X Not Applicable
Name: Maria Martin /ICimiey-Hom s Assoc.
MORTGAGE COMPANY:
Name: wA
X Not Applicable
Address: 1920 Wekmia Way
Address:
City: West Palm Beach State: FL
Zip:33411 Phone:55t-e4s-o555
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name: Dune walk by the Ocean Condominium Associayon,Inc.
BONDING COMPANY:
Name: NIA
X Not Applicable
Address: tttl SE Federal Highway
Address:
City: Start, FL
City:
Zip: 34994 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 1 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
commencing work or recording vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of 20 _by
vs
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this _ day of
1
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
Revised 07/15/2014
20 _by
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
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SUPPLEMENTAL CONSTRUCTION LIENLAW INFORMATION-
-DESIGNER/ENGINEER: x Not Applicable
Name: Maria Martin/ Kimley-Horn &Assoc.
MORTGAGE COMPANY:
Name: N/A
x Not Applicable
Address: 1920 Wekevla way
Address:
City: West Palm Beach State: FL
Zip: 33411 Phone: 581-845-0e65
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Dune Walk by the Ocean Condominium Association, Inc.
BONDING COMPANY:
Name: N/A
x Not Applicable
Address: 1111 SE Federal Highway
Address:
City: Stuart, FL
City:
Zip:34994 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 concurrehcy 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
commencing work or recording vour Notice of Commencement.
V o fl nv�Atiia tut s
_ Signature of Owner/ Lessee/Agent Si at re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �_ � IG�2� COUNTY OF MLL/Ia4e,0
The forgoing instrument was aclinowledgeq Wore me
thisay of 20 y
of person acknowledging )
�.,.p............ .....�,
Personally Known OR Pr uced ification ✓
Type of Identification Produced
Com sign,lyf;•,, ANGEIA St HUFF
�..pybN6 State oi(0aH1p
�,--N-
pt� C,
Commission # FF 234730m c
The forgoing instrument was acknowledged before me
this /8'dayof %�,L -�� .20 L-Lby
Personally Known OR Produced Identification
Type of
Commission No. ,car?oe Notary Public $tglg8))Flodda
ac o N ission�alf
G My Commission FF 108131
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
O
INITIALS