HomeMy WebLinkAboutBUILDING PERMIT APPLICATION10016809 JAislwd 2C
ALL APPLICABLE INFO MUST BE COMPLETED FORAR?kIC ATION TO BE ACCEPTE1
Date: -1I31 118 SCANNED Permit Number:
BY
St. Lucie County RECEIVED
• Building Permit Applicatioll, <
Planning and Development Services A U G O 1 018
Building and Code Regulation Division ST. Lucle County, Permitting
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 Addition / AlteratJ
Address: 3100 N Highway AIA Ft Pierce 34949
Legal Description: SANDS ON THE OCEAN- SECTION 1-
Property Tax ID #: 1425-606- - 0-3 1425 -
Site Plan Name:
Project Name: IAIsland
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
Upgrade LTE equipment on an existing cell tower
CONSTRUCTION INFORMATION:
I Iona wor to e e orme d under tispermit—checka apply:
❑HW nGasTank []Gas Piping _Shutters ❑Windows/Doors
ElElectric 0 Plumbing []Sprinklers Generator ❑ Roof ❑ Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 30,000.00
S Ft. of First Floor:
Utilities:Sewer❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name New Cingular Wireless PCS
Name: Stanley Maclin
Address: 3210 Lake=Emma=Rd— _—_ __--_
=Company:_—Mastec Network Solutions
City: Lake Mary State: FL
Zip Code: 32746 Fax:
Phone No.
Address: 1975 Joe B Jackson Pkwy
City: Murfreesboro State: TN
Zip Code: 37127 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: courtney.ruhff@smartlinkUc.com
State or County License: CGC1515769
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
10016809 JAlsl=d 2C
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: USAEngineering
MORTGAGE COMPANY: x Not Applicable
Name:
Address?818 Cypress Ridge Blvd
Address:
City: Wesley Chapel State: FL
Zip:33544 Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: Sands on the Ocean Section 1 Association
BONDING COMPANY: x Not Applicable
Name:
Address: 3100 N AIA
Address:
City: Ft. Pierce, FL
Zip: 34949 Phone:
City:
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 Count 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 your Notice of Commencement.
Signature o Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Ucense Holder
STATE OF
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Name of person making statement
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Name of per on making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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Commission No. (Seal)
Commission No. (Seal)
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Rev.8/2/17