HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr - 41
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: % d' % 't?• 17• SCANNED Permit Number: r/
BY
St. Luce County RECEWED
Building Permit Application OCT 1 2097
Planning and Development Services
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: To Select from dropbox, click arrow at the end of line III
MENT LOCATION:
Address:
.Legal Description' ow Do Wmrmou Ammouoaui,c MMWGArAm SIs a60vr 4Me 11 mw,omrar 41GraeaeTAMMAIAuxw,.wsxowxwoEaww*wnar m,muwwvoaa 0
Property Tax ID #: 4511-516-0000-000-5 Lot No.
Site Plan Name: Block No.
Project Name: AT&T ANTENNA UPGRADE
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: III
REPLACING EXISTING TELECOMMUNICATION ROOF TOP -ANTENNAS
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6 (n Ji'o f .
CONSTRUCTION INFORMATION: III
Unai worx co oe errormeu unuer rme permn— a
HVAC Gas Tank ❑Gas Piping
Electric 0 Plumbing Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 27500
Shutters ❑ Windows/Doors -
Generator 11 Roof = Roof pitch
S Ft. of First Floor:
Utilities-nSewerE]Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameAPX ING
-
.Name: STANLEYMACLIN
Address:
SP LO
Company: MASTEC NETWORK SOLUTIONS
City: MI ' Qi State: FL
Zip Code: 33322 Fax:
Phone No.
Address: 6100 BROKEN SOUND PKWY
City: BOCA RATON State: FL
Zip Code: 33487 Fax:
Phone No. 954 994 4449
E-Mail: DT2108@ATT.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: ROREY.WANLISS@MASTEC.COM
State or County License: CGC1515769
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION_:
DESIGNER/ENGINEER: _ Not Applicable
Name: APX ENGINEERING
MORTGAGE COMPANY: _ Not Applicable
Name: NIA
Address: 3400 LAKESIDE DRIVE
Address:
City: MIRAMAR State: FL
Zip:33027 Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: ISLAND CREST CONDO ASSOCIATION
BONDING COMPANY: _Not Applicable
Name:
Address: 10660 S. OCEAN DRV
Address:
City: JENSEN BEACH
City:
Zip:34957 Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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
of Nn�r/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF -:, I,.IA q- •e
The forgoing instrument was acknowledged before me
thisJO—day ofoCTnR� 2014 by
--Eye/)nd e wr^cl l
NamNof person reeking statement
Personally Known 1,,0' OR Produced Identification
Type of Identification
n I
( /��i 7l%iirtm
(Signature of No ary Public-
4M
CommissionNdO6/G/ 11 _''�,1�ISdP�GAtIAISSONCGG00
11W.'01 EXPIRES: October21,20
it art:;e 3Wed iN: Notary Public UMBn
REVIEWS I FRONT I ZONING
COUNTER REVIEW
RECEIVED
COMPLETED
Rev. 8/2/17
Signature of Co;ntrar/License Holder
STATE OF FL
COUNTYOF
The forgoing inst: n was acknowledged before me
this Jig -day of 20AI by
AlhIAEL4 (ktrlin
Name of person making statement
Personally Known OR Produced Identification v
Type of Ideptificatiop.
MONIOUE NICOLI
My COMMISSION OF
EXPIRES Januan.
of Notary Public- SMIX
Eo ission No.fT086V& (Seal)
s
PLANS GETATION SEA TURTLE MANGROVE
IEVIEW REVIEW REVIEW REVIEW