HomeMy WebLinkAboutBUILDING PERMIT APPLICATION800642
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED SCANNED Permit Number:
BY
-= r• St. Lucie County
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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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENTLOCATION-
Address: 16800 Okeechobee Road
Legal Description:
Commercial -,L— Residential
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OR 2 0 P018
Pe�l�e1e spa en.
Property Tax ID #: 32-01-244-0039-0008 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK;-
upgrade T-Mobile equipment at exsiting telecom site
N''INFORMATION
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_ HVAC _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ -4z666 6 bb
Shutters
X Generator
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Windows/Doors
Roof Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTMO/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 Codd: 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@ollnwaynecompanies.com
State or County License: CGC1522761
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCON STRUCTION LIEN LAWINFORMATION:
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: EVANS PROPERTIES, INC.
BONDING COMPANY: _Not Applicable
Name:
Address: 660 Beachland Blvd, Ste 301 Vero Beach FL 32963
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.
1 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
commencing work or recordine vour Notice of Commencement
Signature of Owner/ Lessee/Contractor as Agent for Owner
gnat of Co tractor/Lincense Holder
STATE OF FLORIDA �
I�
STATE OF FLORIDA
COUNTY OF / 17 2c
COUNTY C
The fo oing ?'instru nt was acknowledg ore me
this dayy
The fpr�Qi'nginstru7gntwa'acknowledge efore me
this J� day of �Qfby
✓ f 5xrcP(l
Name of person aking statement
Name of person aking statement
Personally Known 1" OR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature ry Public -State ida
(Signature of c- a, '�^
Commission No. l ) O
ADAMEHRLICH
NOW eubfc-StatESForda
No. 5 `
(1�'SSron
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'�'`••. ACAM EHRLICH
mmission :••t • CFF?i5'?8
Notary PuhGp-Sla'� dFmnda
My Camrt. Expres Sep :. "w^!9
Commissal:FF915138
'•,;?'orn„o•`'. 6
v Cpolm. Expires Sep 1, 291
REVIEWS
FRONT
NS
VEGETATION SEATURTLE
MANGROVE
A di F9 11111d6iiiii
COUNTER
REVIEW
REVIEW
RE
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17