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Home My WebLink AboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1/14/19 Permit N r! •-n SCANNED BY Builacing F"eknit Applicati n FEB 4 - 2019 Planning and Development Services 8 K Building and Code Regulation Division BY: fY (1 Ed Virginia Avenue, Fort Pierce FL 34982 L Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential PERMIT APPLICATION FOR: Other III I'PR(JPi)SFr'1fMPRnVFIVIFNT'InrATIhN Address: 6701 S. US Highway 1, Port St. Lucie, FL 34952 Legal Description: The North 100' of Lot 2, Block 3, Model Land Company Subdivision of Section 15, Township 36 South, Range 40 East, according to the map of plat thereof, as recorded in Plat Book 1, Page 41 of the Public Records of St. Lucie County, Florida. Property Tax ID #: 3415-501-0038-000-6 Lot No. Site Plan Name: M190XSRRV / 93398 / 20-8755-1 Block No. Project Name: Sprint / Syscom / Lamar Billboard Small Cell Antenna Setbacks Front Back: Right Side: LeftSide: DETAILED: t2ESCRIPTION OF 1NORK:; Installing pipe mast to hold 1 omni antenna, 1 UE Relay and 1 RRU mini radio. We will run 1 - 3/4" #12 conductor SOO wire from Lamar's breaker papal to our PPC box for power and 1 - 3/4" ethernet (CAT-5E) cable to the UE Relay . We will install 1 - 20 amp breaker in Lamar's breaker panel. ❑HVAC ❑Gas Tank ❑Gas Piping ❑_Shutters ❑Windows/Doors ❑✓ Electric El Plumbing ❑Sprinklers ❑Generator ❑Roof Roof pitch Total Sq. Ft of Construction: 5 Ft. of of First Floor: Cost of Construction: $ 10,000 Utilities: nSewer ❑Septic Building Height: Billboard 35 O_INNER/LESSEE: CONTRACTORS . ' Name Sprint (Michael 8urkhead, KGPCo as Agent) Name Stephen Se'y or& Address:6391 Sprint Parkway, Mailstop KSOPHT0101-72020 City: Overland Park State: KS Zip Code: 66251-2020 Fax: Phone No. (407) 617-0167 Company: Bluestream Professional Services, LLC Address: 3305 Highway 60 West City: Fadbault State: MN Zip Code: 55021 Fax: Phone No. 507-334-2268 E-Mail: michael.burkhead@kgpeo.com Fill in fee simple Title Holder on next page (if different from the owner listed above) E-Mail: stephen.saylor@kgpoo.com State or County License: GOG1020974 If value of construction Is $25110 or more, a RECORDED Notice of Commencement Is required. i- SUPPLEMENTAL CONSTROCTION LIENLAW INFORMATION: `. :..—PP DESIGNER/ENGINEER: _ Not Applicable Name: Faesite Gmup, Incf George S. Raymlds MORTGAGE COMPANY: _ Not A licable Name: Address:3Tao Dayinci cove. suite too Address: City: Peachtreecamm State: cn Zip: 3DO92 Phone iaeai2+ea2teylmaz®tglncaet City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: ThiMyuong hivesMems, LLC BONDING COMPANY: _Not Applicable Name: Address: a731 sable Palm Ciwe, unit 132 Address: City: bleat Palm Beach, Florida City: Zip:3aan 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 Counttyymakes no representation that is granting a Permitwill 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 recording your Notice of Commencement. Sgn tur ofContr__alIctor Dcens older Signature of Owner/Lessee/Contractor as Agent for Owner /1,1'r`y STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5Q, .t na f� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _ day ofiry .26jsby this,.LiZday of3aman .20_�,2by Michael E. Buftead Stephen saybr Name of person making statement Name of person making statement Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced fin^ _ //// — ///J - _ / I . /ALr, � LV �ii. . (Signatur f i- t t o F o' (Signatur f Notary Public- State of a) ° Notary Public State ofp,a,�. Commis' n gn 1>r++n Commission No. (EIA D. CER BI My Commission GG 185952 At <*: Notary Publk:-MiMeso car N Expires 12/082021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REV[ E REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 r � 1 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 8/30/18 Permit Num SCANNED BuilBy diniVimmi jt Ap Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X PERMIT APPLICATION FOR: Other PRQPOSED IMPROVEMEN.T•,LCiCATION .... Address: 6701 S. US Highway 1, Port St. Lucie, FL 34952 15s'l 0— 01�3. b�l2 .2 `van #tea 7Ir , fix` t OCT 05 2018 Permitting Department St, Lucie County, FL Residential Legal Description: The North 1 00'of Lot 2, Block 3, Model Land Company Subdivision of Section 15, Township 36 South, Range 40 East, according to the map of plat thereof, as recorded in Plat Book 1, Page 41 of the Public Records of St. Lucie County, Florida. PropertyTax ID #: 3415-501-0038-000-6 Lot No. Site Plan Name: M190XSRRV / 93398 / 20-8755-1 Block No. Project Name: Sprint / Syscom / Lamar Billboard Small Cell Antenna Setbacks Front Back: Right Side: Left Side: [DETAILED DESCRIPTION OF rWORK. . Installing pipe mast to hold 1 omni antenna, 1 LIE Relay and 1 RRU mini radio. We will run 1 - 314" #12 conductor SOO wire from Lamar's breaker panal to our PPC box for power and 1 - 3/4" ethernet (CAT-5E) cable to the LIE Relay. We will install 1=20 amp breaker in Lamars breaker panel. CONSTRUCTION INFORMATION:° rtiona wor to e errormed un ert ispermit—check all appy: 0HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors ❑✓_ Electric 0 Plumbing Sprinklers ElGenerator 0 Roof = Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ 10,000 SqI FFtt.I of First Floor: _ Utilities: Sewer 0 Septic Building Height: Billboard 36 OW N ERAESSEE: CONTRACTOR: Name Sprint (Michael Burkhead, KGPCo as Agent) Name: r f\\ D t•C! Address:6391 Sprint Parkway, Mailstop KS0PHT0101-Z2020 City: Overland Park State: KS Zip Code: 66251-2020 Fax: Phone No. (407) 617-0167 Company: �CiA•iCn r u�n� i�SSt7C _ �L C, Address: J509 Pt'tn,'\ Sill-CQ+- City: Stater ZipCode: Fax: Phone No. CN 1- a10' cl Ss I E-Mail: michael.burkhead@kgpco.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: 8' r 1. WOOCls mores. Cal CfaGu9irel� sS State or County License: qoQ 7 S if value of construction is $2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: . _ Not Applicable Name: Forosite Group. Inc. / Georges. Reynolds Address: 3740 Davincl court, suite 100 City: Peachbeecomem State: GA Zip: 30092 Phone(404)210-92161j6az@tglnnnet FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Thinh Vuong lavestments.I.Lc Address: 4731 Sable Pine circle, unit o2 City: West Pdlm Beady Fiodda Zip: 33417 Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby n I certify that no work or installation has commenced prior to the St. Lucie County makes no representation that is granting a perm' which is in conflict with any applicable Home Owners Association structure. Please consult with your Home Owners Association ani COMPANY: _ Not Applicable State: Phone: COMPANY: _Not Applicable to obtain a permit to do the work and installation as indicated. nice of a permit. :e the permit holder to build the subject structure or and covenants that may restrict or prohibit such deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do her�y agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Code4nd St. Lucie County Amendments. The following building permit applications are exempt from uncle i�q ing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen)oms and accessory uses to another non-residential use i WARNING TO OWNER: Your failure to Record a Notice oCommencement may result in your paying twice for improvements to your property. A Notice of Commencinent must be recorded and posted on the jobsite before the first inspection. If you intend to obtain finaring, consult with lender or an attorney before J1i & X (/ 1 / Signature of Owner/ Lessee/Contra or A Agent for Owner STATE OF FLORIDA COUNTY OFe— The forgoing instrkkment was acknowledged before me this day - Fit 120a by Name of pegon making statement Personally Known N OR Produced Identification Type of Identification Produced (Signature of N t :I lic- SEIIIAHd�iE�jW ...,' =+ MY COMMISSION 0 FF203015 Commission N ES FebliWI115• 2019 14C 13. '53 r1o,NSNoo ti� Con REVIEWS I COUNTER I ZONING REVIEW I SUPERVISOR REVIEW Rev. Holder OF FLORIDA fY OF forgoing instru ent was acknowledged before me is day of _ r201 �' by Name of person 1�lakingstatement lersonally Known ✓ OR Produced Identification _ type of Identification )roduced C: � ZZS P� (Signature of Notary Public -State of Flo a ) :ommission No. r ot�prr'k. RO E@.STEPHENS * MY AiFF2448% EVIRES:JuBordldlANBudyrtNob4ry fMtd VEGETATION I SEATURTLE I MANGROVE REVIEW REVIEW REVIEW