HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: (Sa5
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential L�
Address: 54 bei e_,2,,(�Cr'V2 Pei S-� b e -%'e
Property Tax ID #t: f -sem -(3p 3 -6Od - fa Lot No.
Site Plan Name: A'o r I i A,-c�_ Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
A -S 4{ ie
CONSTRUCTION INFORMATION. _
Additional work to be performed under this per it - check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric — Plumbing _ Sprinklers _ Generator — Roof Pitch
Total Sq. Ft of Construction::
L r
Cost of Construction: $ 7 -L5d
Sq. Ft. of First Floor:
Utilities: — Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Q f k,v
Name:Blake Cowdell
Address: 713 1 Sate I LA Ke D (, L)A-
Company: Energized Gas
City: _ 6&6 2 State: i'' L
Zip Code: J $ - Fax:
Phone No.
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 License LG34747
iT value OT construction Is :�,cbiuu 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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: 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 BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
EM&-- Qtl,-&u �� ct� C,451Zr�v
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORISTATE OF FLORID r
COUNTY OFA !ACOUNTY OF.-- !� k.J(y
The ing instr meat as acknowled� before me
thi ay of.1-0 2D r;Jt..iby
Name of person mating statement.5
Personally Known I )(� OR Produced Identification
Type of Identification
Produced
'gid g, . pAPtiE. A VEs4A rn)�
SI G 6
(Signature o t Plic1Q� d�kars
Commission (Seal)
The fqfgoing instru ent was acknowled eq before me
thisc-A Nay of , VIA 26by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature ov
ublic 232946�
'•=*'s
Commission 'af XPiR[-S Jure
nui'PP,'A vrit is
�_ _to., o,,.,.,1,rr1TY�tt3$ioiBTY _._ ..---
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
EnP-CfjU,C-d G,--ivs 9,% lic
cr,vra,ma and d'Vztewwl 5,01.1 6pe-aff."46t
'enuka Korlipara
783-1 Sabah Lake Dr
Port ST Lude, FL, 349886
772.-708-0101
February -1-Ot", 2020
Energized Gas here -by, farakslh all tab®v a-Uld onateirials necessairy for the completion of
az ice � Ia Speraifle'd begow:
1) Disconnect gas line to existing generator, reconnect to new generator
2) Price includes all labor, rnaterial -,jnid perm- is
of.
sung
00
I
1786 SVV
iltmore St; Port S-1 ! -�' J
uee FLY 4'3
384 *Dcensed 395, Insured FL3474-7
Toll Free 855-PPOGA54 sTreasure Coast 772-;'77-8;3:3 *Palm Beach 561-752-0214 *Fax 772-318-6673
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 all 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
$100-00 JS due @ S7qninq
$247,00 is @; L.4le DISWIl tion
_
$148.00 15 due (- C o,_aple" ail,
We appreciate the opportunity you have extended us to quotes on this work and would
life to thank you in advanre for your consideration.
ALIthorized signature:
.z d-el� i
Acceptance of Proj?osai
—
(printed name), authorize Energized Gas to
co tris work in accordance ith the abo,(e specifications and conditions. I agree to pay as per
ter n•ts outlined,above.
Signature
Date 6 , 6 2
Thank you for choosing Energizers Gas Inc
"Set-vin,
Setvi1 , 9 the East Coagt of oF;Ori a -
This agreement shall be construed under the laws of the State of Florida. This agreement contains the entire understanding of the
Parties and supersedes all previous verbal or written agreernents: 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 or writtenthe
typed or wr;tten lang ,a!3e shall govern. ,
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