HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -a,S'[ SCANNED Permit Number: LgO,r pi, lO
BY RECEIVED
• iu UNTY St. Lucie County JAN 2 5 P019
Building Permit Applicafi UeeCoun€yant
- 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 Residential
PERMIT TYPE: Telecom Tower -
PROPOSED 1NPROVEMENT'LOCATION: 6375 US Highway 1, Port St. Lucie, FL 34952
Address: 6375 US Highway 1, Port St. Lucie, FL'34952
Property Tax ID #:3415-501-0021-000-4 Lot No.
Site Plan Name: Block No.
Project Name:' AT&T Site Indiar.River Estates
DETAILED DESCRIPTION OF WORK:
Remove 9 antennas and 6 radios. Install 9 new antennas and 9 new radios: _
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit = check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters — Windows/Doors
%4Electric _.Plumbing _ Sprinklers _ Generator . = Roof .. Pitch
Total Sg. Ft of Construction: Sq. Ft. of First Floor: .
Cost of Construction: $/%S01 Utilities: _Sewer _Septic. Building Height:150'
OWNER/LESSEE:
CONTRACTOR:
Name AT&T Mobility -
Name: Stanley Madin _ -
Address:8601 W Sunrise Blvd
Company, Mastec Network Solutions _
City: Plantation Stater_
Zip Code: 33322 Fax:
Phone No.
Address:6100 Broken Sount PkwySuite'6- .
City: Boca Raton State: FL
Zip Code: 33487 Fax: '
Phone No 954-801-4949
E-Mail:
Fill in fee simple Title Holder on next page{ if different
from the Owner listed above)
E-Mail Rorey.Wanliss@mastec.com
State or County License CGC1515769
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. - - • -
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: APxEn9ineerin9 Name:
Address:3400 Lakeside Dr#525 Address:
City: Miramar State: FL City: State:
Zip: 33027 Phone954-744-153B Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
)WNER/ CONTRACTOR AFFIDVIT: Application is herebv 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 .Count
y 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 Nome 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
comme 'n work or-mcordinR your Notice of Commencement.
e
Signatu�ractor/License Holder
Signat Owner/ L ssee/Contractor as Agent for Owner
STATE OF
��Cm
OF ORIDQ O ^r��
COUNTY OFORIDA
COUNTY OFSTATE
The forgoing instrppment was acknowledged before me.
this � day of ��n d'tic9p 20JQ by
The forgoing instr ment was acknowledged before me
_thisa5 day 20_!p by
Iof�,
Name of person making statement.
Name of person ifiaking statement.
Personally Known ' OR Produced Identification
Personally Known—' OR Prod do
Type of Identification
Type of Identificaticw- aiE FERR
Produced
Produced :::^"j4it:., gGG09j577
?AYPIRES APnI t2. 2021
•;:. �• MARIE FERRER'
(Signature of Nota atdibFAP!
(Signature of Notary Public- State of Florida
EXPIRES Apol 021
Commission No.
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
-REVIEW
REVIEW
DATE
�-
RECEIVED
1(
DATE
COMPLETED
Rev.y/2b/is , A