HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Q
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Building Permit Ag8A-ign MAR 3 0 2017
Planning and Development Services BY PERMITTiNG
Building and Code RegulationDivisionFSt. Lucie Conn St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce C 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Alteration III
PROPOSED IMPROVEMENT LOCATION:
Address: 21715 Orange Avenue, Fort Pierce 34945 (Verizon Wireless Site# 68837)
Legal Description: Book 3416 / Page: 2378
PropertyTax ID »: 2208-311-0001-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Verizon Wireless Site# 68837 ADAMS RANCH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
At existing communication site, modification of 6 existing antennas reusing associated coaxial cable.
Also to install 6 diplexers and 6 BIAS-T units at antennas and install 6 diplexers at grade.
CONSTRUCTION INFORMATION:
❑HVAC 0 Gas Tank
❑Electric ElPlumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2 s, d OCR
Piping ❑_Shutters ❑Windows/Doors
nklers 1:1 Generator ❑ Roof
_ S Ft. of First Floor:
Utilities: OSewer❑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 - Veronica
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 CONSTRUCTIONLIEN'LAW 'INFORMATION:.
DESIGNER/ENGINEER: x Not Applicable
Name: Marla Martin /IGmley-Horn B Assoc., Inc.
MORTGAGE COMPANY: X Not Applicable
Name:
Add ress: 192o wakiva way
Address:
City: West Palm Beach State: FL
Zip: 33411 Phone: 561-845-0665
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name: 4H Rench, Inc.
BONDING COMPANY: X Not Applicable
Name:
Address: P.O. Box14920
Address:
City: rL Pierce, FL
City:
Zip:34a7s 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
commencing work or recording vour Notice of Commencement.
s
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA n STATE OF FLORIDA_
COUNTY OF `x� COUNTY OF �jffA _`K _ ee
The doing instrument w s acknowledged before me The f,or��o,i��ng instrument was acknowledged before me
this day off 20 ).�by this p��day of �p1/IC.�'� , 20 I T by
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(Name of person acknowledging) (Naftiqo& ersgp acknowledging )
(Signature of Notary Public- State of Florida )
(Signature d Notary Public- State of Florida )
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error Expires04118/2018
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