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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • � 6 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 PERMIT TYPE: C 4,5 PROPOSED IMPROVEMENT LOCATION Address:__ 7 �t1Ci1�. Property Tax ID #: /j� Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: JG CONSTRUCTION INFORMATION: Additional work to be perfor 'ed under this permit – check all that apply: Mechanical _ Gas Tank Gas Piping Shutters Electric _ Plumbing `Sprinklers Generator Total Sq. Ft of Construction: Cost of Construction: $ G����(,! , (� Sq. Ft. of First Floor: Utilities: —Sewer —Septic Windows/Doors Roof Pitch Building Height: OWNERAESSEE: CONTRACTOR: Name"� Name: Blake Cowdell Address: ?+' �` Company: Energized Gas City:G �1G; Stater Zip Code: 5 cl? Fax: Phone No. Address: 9786 SW Biltmore St City: Port ST Lucie State: EL Zip Code: 349$4 Fax: Phone No 7727778933 E -Mail: Fill in fee simple Title Holder on next page S if different from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement E-Mailenergizedgenerators@gmail.com State or County License LG34747 Commencement is required. 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 HE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YnuR uFNOER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." 6_c)ej� cow" Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORID COUNTY OF J I COUNTY OF The f r ging instr nt was acknowledged before me this ay of 2D y Thetroinginstr m nt was acknowled before me this of 2 by (Air p Name of person making statement. Name of person making statement. Personally Known Y OR Produced Identification Personally Known 'K OR Produced Identification Type of Identification Type of Identification Produced. Produced (i)— � & , 0 L 0 ( (Signa l .. ...NCA DANIELE.CGOI�#SALVES (Signature DANIELLEG0HCA_ _S I ,rr PL � v�_- Comrr> # ri�o fi' �`�CO ISSIt3N; GG 232 �a1I n Comm'ssslo I# p. klyCJM�vi[S IUN#�GG�5��at� y r4 a' fwXPIRES. June 2a 2022 ��y�k� = Jane 23, 2022 � �. Bonded Thru Notary PON. Und rw6la s _:-°F Bonded i i ru Notary Fu li llndarw iters _ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2///19 IMED ow *Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pierce, FL, 34981, Fax 772-318-6672* *Palin Beach 561-752-0214, 1700 Latham Rd, Suite 2, West Palm Beach, FL, 33409* Proposal / Agreement E'o e'- -,Da4�4- Marino 7316 Mystic Way Port Saint Lucie, FL 34986 772-464-6648 Bogey772@vahoo.com May 5, 2020 1) Thompson Gas to supply and install (1) customer owned 500 gallon underground LP tank with extended gas line to generator and final connect 2) Obtain all permits & inspections needed 3) Price includes 70' service 4) Price includes backfilling and removing dirt 5) Price does NOT include filling the tank with propane NOTE: Tank and line to be installed by Thom son Gas or the sum q : 414 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 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 $495.00 is due @ Signing ,— $3,905.00 is due @ Generator startup We appreciate the opportunity you have extentlea us ro quore on cnis wurx ai►u wuuru like to thank you in advance for y ur consideration. i Authorized signature: Brian Orr Acceptance of Proposal IIVO fi' MAI 11� / A/0 -I"X 0 G r(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. Signature ©ate /1 Z 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 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 or written, the typed or written language shall govern. Page 2 of CONTRACT TERMS AND CONDITIONS Installation will comply with all local and state regulations and be consistent with standard industry code. Installers are 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 proce"ss is initiated. Customer is responsible for obtaining HOA/POA approval. Installer 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 PRINTED NAME SIGNATURE 7k 1- f`f. z DATE Page i o