HomeMy WebLinkAboutBUILDING PERMIT APPLICATION•i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
SCANNED Permit Number:
BY
St. Lucie County RED
Building Permit Application MAY 11201
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _) Residential
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 16800 Okeechobee Road
Legal Description:
Property Tax ID #: 32-01-244-0039-0008 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
J.jDETAILED DESCRIPTION OF WORK:
upgrade T-Mobile equipme t at exsi..ng telecom site
s-ep/oul+-eA/ e1'�2 aKY/�4h4s 1f/�-oeP 2,
HVAC
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 12000
_ Gas Piping
_Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Roof pitch
Utilities: _Sewer _Septic Building Height:
OWN E R/, LESSEE:
CONTRACTOR:
Name TMO/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@olinwaynecompanies.com
State or County License: CGC1522761
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
Na
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: EVANS PROPERTIES, INC.
Address: 660 Beachland Blvd, Ste 301 Vero Beach FL 32963
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
Zip
_Not Applicable
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 inspectio you intend to obtain financing, consult with lender or an attorney before
commencing wo_rkor ding your Notice of Commenceme
r
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Signature of O ner/ L sTe-/Contractor as Agent for Owner
Signatur6 of C ntractor/License Holder
STATE OF FLORIDASTATE
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OF FLORID4q, //n
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COUNTY OF v
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The for oing instru ent was acknowledged before me
The f�o�r�Poing instrument was acknowledged efore me
thisiFday of � 20a by
this of &Z _, 20 by
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Name of persy� �making statement
Name of person making statement
Personally Known ! � OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
'e
(Sig a ro N t u '
la)
(Si
natur of Notary Public -State of Florida )
COm "' ADAMEHRLICH
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CO
'" ADAAfEHRLICH Seal
(Seal)
Commissar #FF 915138
',. _ otary ofm- Late of Fonda
Commission # FF 915138-
`g Comm.Ew mSep1.2019
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My Comm. EaJires SeD 12019
REVIEWS
FRONT
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SUPERVISOR
PLANS
IF
SEA TURTLE
MANGROVE
VEGETATION
COUNTER
REVIEW
REVIEW
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
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DATE
it
COMPLETED
Rev.8/2/17