HomeMy WebLinkAboutSUBMITTED PAPERSv ,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-10-14 SCANNED Permit Number:BY
--:- St. Lucie County
e
Building Permit Application
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 Residential x
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMIPROVEMENT LOCATION: .
Address: 1916 Wyoming Avenue
Legal Description: Orange Blossom Estates First Addn BLK 1 LOT 8
Property Tax ID #: 2421-602-0008-000-3
Site Plan Name: Mahesh Patel
Project Name: Mahesh Patel
Setbacks Front Back:
Right Side: Left Side:
Lot No. 8
Block No. 1
DETAILED DESCRIPTION OF WORV-17
$k
HVAC Equipment Change Out; Make- Carrier; A/H Model: FX4DNF037L00; C/U Model:
CAJIG NA0360OG l
CONSTRUCTION INFORMATION:' >:
LJHVAC Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3729.00
I'LL - U
Piping
frs 11 Generator
S Ft. of First Floor: _
Utilities: Sewer E Septic
aWindows/Doors
DRoof
Building Height:
OWNER/LESSEE: -
CONTRACTOR:'
Name Mahesh Patel
Name: Donald Wayne O'Bryon
Address: 1916 Wyoming Avenue
Company: Preferred AC 8 Mechanical, Inc.
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.561-762-1632
Address: 1643 Donna Road
City: West Palm Beach State: FL
Zip Code: 33409 Fax: 561-478-0089
Phone No. 561-689-1093
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: tricia@preferredacmech.com
State or County License: CAC1817665
If value of construction is S2S00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C6NSTRUCTI0NiIEN LAW INFORMATIQN:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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, consult with lender or an attorney before
commencine work or recordi otce of Commencement.
Signature of
STATE OF FLORIDA
COUNTY OF Palm Beach
The forgoing instrument was acknowledged before me
this _ day of 20 14 by
orally Known x
of Identification
Commission
Revised 07/
OR Produced Identification
TRICIA RADD
Commission # EE 11:
My Commission Exp
July 18. 2015
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Palm eaach
The forgoing instrument was acknowledged before me
this 10m day of Decem5er . 20-g by
person
Personally K96wn x OR Produced Identification
Type of Id
Je6tification Produced
No. ee11as4e °"` "°%, cTR,ISFIA RADD
Cohr�if55ion # EE 113546
My Commission Expires
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
SERVICE
AND
� ��
INSTALLATION
Air
WPB OFFICE
(561) 6B9.1093
Conditioning's
WPB FAX
(561)478.0089
PSL OFFICE
(772) 878.7577
PSL FAX
(772) 878-7510
Mechanical, Inc.
TOLL FREE
(800) 482-1989
AGENT AUTHORIZATION LETTER
Date: 12-10-2014
UNLIMITED
STATE CERTIFIED
CAC1817665
1643 DONNA RD.
WEST PALM BEACH. FL 33409
831 SW KINGS HWY
FORT PIERCE, FL 34945
1 MAHESH PATEL do hereby grant permission
(Property Owner's Name)
to Donald Wayne O'Bryan 61-589-1093 to act as my agent in Agents Name all aspects in
- - - - . (Name and -Phone Number of Authorized Agent)
order to obtain a building permit from the St. Lucie Countv for property located
(Municipality)
at 1916 WYOMING AVENUE 12421-602-0008-000-3 This will allow my agent to answer
(Property Address / Parcel Control Number)
any and all questions on my behalf and to sign any and all documents for me: however, I accept full
responsibility to ensure that my project meets all zoning and building code compliance.
This authorization shall be effective on the date this affidavit is notarized and shall remain in
effect until the final inspection has been approved by St. Lucie County
(Municipality)
This authorization acts as a durable power of attorney only for the purposes stated herein.
The undersigned understands the liabilities involved in the granting of this agency and accepts
full responsibility, thus holding the building department harmless, for any and all of the actions of the
agent named, related to the acquisition of development permits for the aforementioned
MAHESH PATEL
Printed Name
STATE OF: Florida
COUNTY OF: Palm Beach
The foregoing instrument was acknowledged before me this 10th day of December 20 14 ,
By: MAHESH PATEL
who (check one) [ ) is personally known to me or [x ] has
NOTARY PUBLIC, State of Florida
My Commission Expi „ TRICIA RAvv 40t
•`."'�fission N EE 11
Comm es
"Ciai'YIDo My Commission Expires
i,av 18, 2015