HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: 1:111-051
- BY
St. Lucie County
M` Building Permit Application a , �0' oQ L�Q
Planning and Code
ion Division
�I In l _^�
Building and Code Regulation Division 1 a
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Tewe,collfuon Residen al N/A
PERMIT APPLICATION FOR: Other
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Legal Description: an.ae+xer R..RROFssc TFOa: EEO nrsmoRRNxII...Ov5Emo9]DR.IDNWT91E9ubTMTN N 4229e9wsuse MTN N ss 999wI9e.IeR.sN NonemE ions vr.m NEC 9s<9w9na9F9TON LION
rNs 7:5244E41e5R.rxs aeae 111 lei]AlT.TN NO TO o ENle v Rro N uofsse.Tl ae9YasuaN LN ltll.el R row MV OF .TN s vv 99 EU WNNusv.n Ffro Eu OF SEC, eNsuo E UHles SO TO FVBPTe38I OR 9771'999p
Property Tax ID #: 1201-111-0002-000-5
Sire Plan Name: 5120 American Tower/ M113XCO58 Sprint- Collocation
Proiect Name: 5120 American Tower / M113XCO58 Sprint - Collocation
S,etbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
rDETAILED DESCRIPTION OF WORK:
Lot No. N/A
Block No. N/A
Existing Communications Tower: Installation of 3 new panel antennas and installation of 3 new RRU's
(radio units).
CONSTRUCTION INFORMATION:
OHVAC UGasTank
Electric 1:1Plumbing
Total Sq. Ft of Construction: 300
Cost of Construction: $ 20,000
L)Gas Piping
[]Sprinklers
(all apply:
_Shutters ❑Windows/Doors
Generator Roof NSA Roof pitch
S Ft. of First Floor: N/A
Utilities. Sewer oSeptic Building Height: N/A
O W N ERAESSEE:
CONTRACTOR:
Name 5 sA
Name: e4EDS
Address c.)C
Company: 4/
City: k V 1Aate:
Zip Code:":D'E) Fax:
Phone No.
Address:q�o 1?'AAQ Re0501 %(K4
cityZ_C5brflax State:r-L•
Zip Code: .L 7 Cq Fax:
Phone NOW-7)CIJI-QG-1 (
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:Per-ph Cl(r asca i S - Cam^
State or County License: SCC/3/ J SO 9-1
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
113111113
ow Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial T—, col—tion Residential NIA
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION;
Address: 13698 Indrio Rd Ext., Fort Pierce, Florida 34945-4003
Legal Description: QIMWMTPM OFMC�BEC) AT 6E6CA"WSIJCf6E8Sfl6I8Ff 1101 17 11 EIE857R. . . . . . . 1.. 11 19E =001...AIOF7To xua
Tx8?1 IWIM"MWMUO IW%W$WWII E"W8 UWM "TOE
PropertyTaxlD#: 1201-111-0002-000-5 Lot No. NIA
Site Plan Name: 5120 American Tower / M113XC058 Sprint- collocation Block No. N/A
Project Name: 5120 American Tower / Mil 3XCO58 Sprint - Collocation
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: NIA
DETAILED DESCRIPTION'OF WORK:
Telecommunications Tower Collocation of Electronic Equipment: Replacement of existing transmission
panels on the cell tower and electronic equipment on ground level. I
CONSTRUCTION INFORMATION:
MUU I U1 I U I II I UU
LIU 1141 �U 11% LU Uld [J HVA Gas Tank
ZElectric EJ Plumbing
UIIUe1 LIIIb
E]Gas
OSprinklers
PUI IT IIL—ClIeLK all apply:
Pi. Shutters
M
Generator
Windows/Doors
Roof N/A I Roof pitch
Total Sq. Ft of Construction: 300
Cost of Construction: $ 20,000
S Ft of First Floor: N/A
Utilities: Sewer _Septic
Building Height: N/A
OWNER/LESSEE; e,
CONTRACTOR:
Name- Jel-,A�ELqe A -6/0 h
Name: t3f.QJ0Min
ULN
Address:-
Company: ATS
City: State:
Zip Code:- Fax:
Phone No.
Address: 450 S F;onnld:RPld
fah— &yd
City: I J)rQJAf1-)()(1 - seate:EL
Zip Code:, S ( ) Fax:
Phone No. 401-42Z-010-71
E-Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail:
pC[tni-fhnQ(a0CWSCAt.CW_
'
State or County License: =1,;l)6o0-70
If value of construction Is $ZSOO or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER*----,--_ Not Applicable
Name:INFINIGY- ChristopherJ.Warren
MORTGAGE COMPANY:
Name:
X Not Applicable
Add reSS: 1401 Town Plaza Ct, Suite 2040
Address:
City: Winter Springs State: FL
Zip: 32708 Phones-27-24w- 678-444-4463
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Inddo Land Group, LLC
BONDING COMPANY:
Name: NIA
x Not Applicable
Address: 7900 Glades RD Ste 402
Address:
City: ewe Raton
City:
Zip:3M34 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
commencine work or recordine vour Notice of Commencement.
Signature of
as Agent for Owner I Signature of
Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 0MrJq4 COUNTY OF DraVl qJ
The forgoing instr ent was a knowledged before me The for oing instr Went was acknowledged before me
this going
IPCPm�;J[., 20f2by this �dayof�M1i- .20J7 by
ftcAmfin Evt v brolornfo F-aLty
-lame of person making itatement Name of person makingstatement
Personally Rhown OR ProducedYdentification Personally Known OR Produced Identification " "'-
Type of Identification Type of Identification
(Si�nattSYe of Nc
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
Florida
156478 ? I Commission No.
1 W3012021
N Ruiz
156478
FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW -REVIEW-- REVIEW
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