HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONMIDWAY RD 3C r iz
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
St. Lucie County�G
Building Permit Application 9
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 RIMPritial
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION;
Address: 5690 way Rd, Fort Pierce, FL 34981 Vi r ar) M N TAL `DR
Legal Description:
Property Tax ID #: 3406-501-0040-000-5 Lot No.
Site Plan Name: MIDWAY RD Block No.
Project Name: 3rd Carder Overlay
Setbacks Front Back: Right Side: Left Side:
DETAILED,DESCRIPTION OF WORK: „, :•
Replacing 9 antennas and 9 radios on 300' Self Support Tower
CONSTRUCTION INFORMATION'"
ACIClitionalworKtoB-e-De-ffor—meaunder tispermit-check all apply:
In
�HVAC GasTank OGasPiping_Shutters ❑Windows/Doors
Electric Plumbing ❑Sprinklers ElGenerator 11 Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 27,500 Utilities:n Sewer 0 Septic Building Height: 300'
OWNER/LESSEE:
CONTRACTOR:
Name AT&T Mobility
Came: Stanley Marlin
Address: 8601 W Sunrise Blvd
Company: Master Network Solutions
City: Plantation State:
Zip Code: 33322 F x:
Phone No. (954) 916-9696
Address: 6100 Broken Sound Pkwy Suite 6
City: Boca Raton State: FL
Zip Code: 33487 Fax: 561-988-5829
Phone No. 561-962-9838
E-Mail: dt2108@att.com
Fill in fee simple Title Hol r on next page (if different
from the Owner listed above)
E-Mail: bocaratonpermitting@mastec.com
State or County License: CGC1515769
SUPPLEMENTAL CONSTRUCTION LIEN LAW -INFORMATION:
DESIGNER/ENGINEER: _
Name: APX Engineering
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 3400 Lakeside Dr#525
Address:
City: Miramar
Zip: 33027 Phone:
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name: FCC Environmental LLC.
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 2175 Point Blvd Suite 375
Address:
City: Elgin, IL
City:
Zip: 61023 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
commencine work or recordine vour Notice of CmmrnPnrPmPnt-
_ Signature of Owner/ Lessee/Agent
Signature of Co ractor/License Holder
STATE OF FL IDA STATE OF FLORIDA
COUNTY OF COUNTY OF tl drn kulc'1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-L4 dayof (VAVf�2j fV1KW 20Eby thiisyL X day of K1b�111y)b 20 � by
Rim -A 0. Krt fd�' W01IA
(Name of person acknowledging) (Name of erson acknowledging j
Notary Public -State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/20
of Notary Public -State of Florida )
Personally Known OR Produced Identification VI/
Type of Identification Producel 4ay �IP>o{Af�l.i
MONI&EINICOLI NOBLEI Commission
My COMMISSION #FF080936
MON19MOICOLI NOBLE
My COMMISSION #FF080936
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ZONING
SUPERVISOR
PLANS
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DATE
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INITIALS
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