HomeMy WebLinkAboutBUILDING PERMIT APPLICATION813700 -`• Sprir ')Macro Upgrade mi13=160 r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number: _ lap • ciN�)
BY
- I "�'1 St. Lucie County RECEIVED
Building Permit Application .IUN 13 2018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982
St. Lucie County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Rt2OPOSED !*MPROVENC NT LOCKT,f N:
II
Address: 2651 Minute Maid Rd
Legal Description:
Property Tax ID #: 1231-111-0003-000-5
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Left Side:
Lot No.
Block No.
{9
ETAILEO D SCRIPTI(* OF WORK r x
upgrade equipment at existing cell tower site
VAC _ Gas Tank
\
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 25,000
ms perma — cnecx an Gnat appry:
_Gas Piping _Shutters —Windows/Doors
Sprinklers _ Generator _ Roof Roof pitch
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Building Height:
OWNERAI SSEE Al
"Sprint/
CONTRACTOR: ,
Name Crown Castle
Name: Armando P Quintero JR
Address: 6420 Congress Ave., #2000, Boca Raton, FL 33487
City: State: _
Zip Code: Fax:
Phone No. 561-922-1230
Company: Intellisite Inc.
Address: 3771 Belle Vista Dr. E
City: St. Pete Beach State: FL
Zip Code: 33706 Fax:
Phone No. 561-922-1230
E-Mail: adam.ehrlidh@crowncastle.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: adam.ehdich@crowncastle.com
State or County License: CGC1521308
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
StJ P MEi T E CCU STaf
4.1CFLaN 1E 'r-. 1!`RirtI
FORM 7tQ'�I x-,
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name' J and L Hale LLC
BONDING COMPANY:
Name:
_Not Applicable
Address: 398 SE Naranja AVE Port St Lucia, FL34983
Address:
City:
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, cons ��It with lender or an attorney before
commencine work or recordine vour Notice of Commencement. 6\
Signature of Ow r/ Lessee/Contractor as Agent for Owner
actor/License Holder
ignature IFL
STATE OF FLORIDA�u I�
STATE Ol I�
COUNTY OF ?,- ALL
Y O
COUNTF //
The f oing instrument was acknowledge efore me
this day of /_ 20Vby
The f ng instr, a was ac nowledge efc re me
thisn�o�ay of 20 '
_j
lvi`s "� e-o
/
rna.r)d-o V1tj
Name of perso ,Taking statement
Name of pers n making statement
W
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatur o ubl - t
(Signature of Notary Pu F n a
,^; '1 ACAM EHRLICH
Commission No. , •: �. i(S c1ZryPahllc-StateotFladda
nup
r a: r^oar,, 11cc COLE GRANT
ommission No. + Nolef��Ublie State
- Commss:mYFF 915t38
�o: - of Florid
Commission # FF 181486
"'•'„Fos: -"F,.c hly Corm. Exons Sep 1, 2019
My Comm. Expires Mar 31 Pal
REVIEWS
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SUPERVISOR
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bonded Ihr,
SEATURTLE`A
ugh National Notary Ass
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COUNTER
REVIEW
REVIEW
REV EW
REVIEW
REVIEW
REVIEW
DATE
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RECEIVED
10In
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DATE
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COMPLETED
Rev.8/2/17