HomeMy WebLinkAboutToth gas app and signed contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
F
Building Permit Application
Planning and Development Services
Ruilding and Code Regulotion Division'
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: C 5
PROPOSED IMPROVEMENT LOCATION:
Address: 110 3_A 8401-e* YN6 E (J i rec-P E�.
Property Tax ID #: �_3 r� -3 - go 0 - & 00 " q Lot No.
Site Plan Name:
Project Name: `—bf('�
Block No.
DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank ?Gas Piping _ Shutters _ Windows/Doors
Electric
Total Sq. Ft of Construction:
Plumbing _ Sprinklers
Cost of Construction: $ �j 7 of S'QG
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name nellC I 7—of?
Name:Blake Cowdell
Address: NO 3 q Mull (
Company: Energized Gas
City: c + -"fCe State:r�
Zip Code: � tj1Lfs� Fax:
Phone No. 7 a G 3 t'
Address:1786 SW Biltmore St
City: Port ST Lucie State: FL
Zip Code: 34984 Fax:
Phone No7727778133
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail energizedgenerators@gmail_com
State or County LicenseLG34747
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
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
VYYIV Cr-V wry I r(MA UK AFFIUVI I : 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDINC YOUR NOTICE OF COMMENCEMENT."
Signat re kof Owner/ Lessee ;oont�ractor as Agent for Owner
Signature of Contractor/Licens older
STATE OF FLORI STATE OF FL
O
COUNTY OF COUNTY OF
Th =rgoing ins r ment w s acknowlecl d before me
thiy of 20 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
l
ignature of Nota RA. tote NCALVES
•: ;, 5 MY COMMISSION # GG 232W
Commission No. �. EXPtR 5I27,2022
FOFFt4 •' Bonded Thru 140 tary Public Underwriters
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
The orgQing instr e .t was acknowledge before me
this y of 20by
M' Ca[ 1
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(5ignatu of; Pubes
'� � w • MY COM1ti+l1SSIOPi
Commis a EXPIRES: June 27,
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
Proposal / Agreement
Danny Toth January 3Y't, 2020
11039 Muller Road
Fort Pierce, FL, 34945
772-201-3181
Dare Istcfassconst:ruction(� '.yahoo.con)
Energized Gas hereby agrees to furnish all labor and materials necessary for the completion of
services as specified below;
• Supply and install (1) 199,000 BTU Rinnai tankless water heater outside
Connect to existing gas line and cap off gas line at old water heater location
TOTAL: $2,500.00
All City Plumbing 11 to demo recirculation pump, disconnect and remove
existing water heater and tie into existing plumbing lines to new water heater,
They will also pressure test lines for leak
TOTAL: $1,200.00
Energized Electric to install disconnect switch on new water heater
TOTAL. $95.00 /
For the suin of.
_..__ 3,1795- 0
1786 SW Biltmore St, Part ST Lucie, FL, 34984 *Licensed & Insured FL34747
Toll Free 855-PROGAS4 *Treasure Coast 772-777-8133 *Pain Beach 561-752-0214 *Fax 772-318-6673
TERMS:
Charges & Payments: Charges are due in full at time services are rendered unless otherwise stated below. Contractor may
charge and customer agrees to pay a late fee for ail past due payments, such fees not to exceed the maximum allowed rate by
applicable law. Customer shall be responsible and agrees to pay for all charges billed, applicable taxes, applicable legal fees and
other charges/fees.
Proposal/Contract pricing good for 30 days from Proposal/Contract date
$200.00 is due @ Signing
$3,595.00 is due @ Completion
We appreciate the opportunity you have extended us to quote on this work and would
like to thank you in advance for your consideration.
Authorized signature:
Ic ael Fl xman
Acceptance of Proposal
14 _____(printed name), authorize Energized Gas to
complete the work in accordance with the above specifications and conditions. I agree to pay as per
terms outlined above.
Date"? 2.C�
Sianature
Thank you for choosing Energized Gas Inc
"Serving the rust Coast of Florida"
This agreement shall be construed under the laws of the State of Flor;da. This aareernent contains the entire understanding of the
parties and supersedes all previous vernal or written agreements: there are no other agreements, representations or warranties not
set forth herein. if any conflicts exist in this agreement between terms which are printed and those which are typed ar written, the
typed or written language shall govern.
Pace 2 of 3
CONTRACT TERMS AND CONDITIONS
Installation will cornpiy with all focal and state regulations and be consistent with standard industry code.
Energized Gas, Inc, is not responsible for landscaping repairs as a result of installation*. This includes but
is not limited to; damaged/broken sprinkler lines and/or damaged/broken water or sewer lines.
This contract price does NOT include bonding gas lines, converting outlets, converting appliances or
carbon monoxide detectors
Additional charges may apply if rock and/or roots are encountered during the excavation process.
Deposit will be forfeited if customer cancels after the permit process is initiated.
Customer is responsible for obtaining HOA/POA approval. Energized Gas, Inc. is not responsible for
customers failing to obtain final approval.
If home is located in flood zone, the additional cost will be the responsibility of the homeowner if a tank tie
down, or buoyancy pad is required per the building department
A site survey of your property showing all property lines is required to pull a permit and can be submitted
along with this signed proposal,
*To include sod replacement a charge of $395 applies.
CUSTOMER SIGNATURE FOR ACKNOWLEDGMENT OF ABOVE TERMS
10��Ij J.
PRINTED NAME
SIGNATU E
MATE
Page 3 of'3