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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION6800245 'r 7 T-Mobile GED A2P0105A ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` Date: ��a3 ld ,SCANNED Permit Number: 1��3�Oro6� BY 0 - � - St. Lucie County REC�iVE® Building Permit Application MAR 2 3 2018 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: 5041 St. Lucie Blvd. Legal Description: Property Tax I D #: 1431-211-0001-000-2 Site Plan Name: Project Name: Setbacks Front Back: Right Side: upgrade T-Mobile equipment at exsiting telecom site 1 evi5l- ,8 concre r' e - _ HVAC �asTank _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 12000 Lot No. Block No. Left Side: c�11 t�ew en•erce,Fo� ©n nis permn —cneCK an tnat apply: _Gas Piping _Shutters —Windows/Doors _ Sprinklers _ Generator _ Roof Roof pitch Sq. Ft. of First Floor: _ Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CQNTRACTOR - _ -Name-LMO/Crown-Castle -Name Daniel Ault Address: 6420 Congress Ave., #2000, Boca Raton, FL 33487 City: State: _ Zip Code: Fax: Phone No.561-922-1230 Company: Glotel, Inc. Address: 3060 Orange Gorve Trl, Naples, FL 34120 City: State:_ Zip Code: Fax: Phone No. 239-776-5884 E-Mail: adam.ehrlich@crowncastle.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: danault@ollnwaynecompanles.com State or County License: CGC1522761 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUP.RL+EIVIENTAL CON5TRUCTtIQN:LIEN LAN/ INFORMATION; DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: Charles H Fox David A Hoines Bonnie K Hoines BONDING COMPANY: Not Applicable Name: Address: 3081 ECOMMERCIAL BLVD#200 FortLauderdale, FL33308 City: Address: City: Zip: 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 . commencinR work or record.'record.4m our Notice of Commencement. Signature of Owner/ I essee/ ontractor as Agent for Owner Sign6fure of Co tractor/License Holder STATE OF FLORIDA }� OF Rd �J�er�� STATE OF FLORIDA PC COUNTY on, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this '2 \ day of AN LWX- t, 20 Ile by this ] �_ day of rs c,.r4 26J Ay luz,r 4, i(a QQnkP L . Uij- Name of p�erso making statement Name of person making statement Personally Known 1�-'OR Produced Identification Personally Known 6-� OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida CSignature of Notary Public- State f Flori CommisslonTNo. :'�^"'fP��($��1d E.HRLICH ommisslon o. : ea Q ADAM EHRLICH Nott*Pubro-State VFWda ,•� Notary Pubro-State ofFlodda - ComdmWFF915138 =,y Comn�ss`on SFF 9151?8 REVIEWS FRONT PLANS VEGETATION SEATURTLE MAN R ZONING SUPVRVI§OR COUNTER REVIEW RE IEW RE IEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17