HomeMy WebLinkAboutBUILDING PERMIT APPLICATION3`800427 ATT LTE 5C w _
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,q
Date: 3' 13' I� (,CjJ� 'SCANNED .Permit Number:
Y B
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
St. Lucie County
Building Permit Application
Commercial X Residential
Address: 6425 Russakis Road Fort Pierce, Florida 34951
PropertyTax ID #: 1303-243-0001-000-7
Site Plan Name:
Project Name: ATT LTE 5C 10126636
DETAILEDDESCRIPTION OF WORK:
)pgrade of equipment at existing cell tower site
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
L/'Ilectric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 19,000
Sq. Ft. of First Floor:
Lot No.
Block No.
—Windows/Doors
Roof Pitch
Utilities: -Sewer _Septic_ Building Heigkt:
OWNER/LESSEE:
CONTRACTOR:
Name ATT/ Crown Caste
Name: Stanley Maclin
Address: 6420 Congress Ave, 92000
Company: Mastec Network Solutions, LLC
City: Boca Raton, FL State: _
Zip Code: 33487 Fax:
Phone No.561-544-4965
Address: 6100 Broken Sound Pkwy, #6
City: Boca Raton State: FL
Zip Code: 33487 Fax:
Phone No 561-962-9838
E-Mail: SFLPermits@crowncastle.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail SFLPermits@crowncastle.com
State or County License CGC1515769
it value or construction is $z!Puu or more, a ittcOxutD 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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name: Russakis Imestments LLc
BONDING COMPANY: _Not Applicable
Name:
Address: 8801 Indric Rd
Address:
City: Fort Pierce, FL
City:
Zip: 34951 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 JOB SITE BEFO THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN AFrORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Leisi(e/Conthaffor as Agent for Owner
SignatQl!_l Contractor/License Holder
STATE OF COUNTY OFORIDAC—`M 13���
OF ORID1a`m 2Xa�
COUNTY
OFSTATE
The for oing instrument was acknowledged before me
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The forgoing instrument was acknowledge before me
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this day of 20y by
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Name of person making statement. \\\ �y M. y^ ///
Name of person making statement.
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ersonally Known x OR Produced Identification
Type of Identification �
type of Identification
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Commission No. (Sedill1111111 11110
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Commission No.l7i 22
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Rev. 2///19