HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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 TYPE: LP Gas
PROPOSED IMPROVEMENT LOCATION:
Address: u• ut %.jmdrluer Five, tori tierce, t -L .54ytTZ
Property rax ID u: 3404-501-0553-010-1 Lot No.
Site Pian Name: Ney - Generator Block No.
Project Name: Ney-Generator
[.DETAILED DESCRIPTION OF WORK:
install 10' of new gas line from existing line to new 16kw pen and connect
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank VGas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 756.60 Utilities: —Sewer _Septic
_ Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kenneth J. Ney
Name: Tom Fite
Address: 5407 Oleander Ave
_
Company: Ferrellgas
city: Fort Pierce State: FL
Zip Code: 34982 Fax:_
Phone No. 772-370-3582
Address: 3232 SE Dixie Hwy
_
City: Stuart state: FL
zip code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-mail: donn.ney@stlucieschools.org
Fill in fee simple Title Holder on next page t if different
from the Owner listed above)
_
E -Mail_ KimWilkins(nferrellgas.com
state or County License_ 31370
- .. aww..1 .,,u. e, a n-a.vnucu nonce oT wmmencement is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
Name:_
Address:
City: State: _
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Address:
Zip:
_Not Applicable
UWNW LUN I KALI UK 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 ATSORNEY BEFORE RECORDING YOUR NOTICE OF CnMMFNCFMFNT_"
Rev. L/ // 17
Signature of Owner Lessee/Contra for as Agent for Owner
Signature of Contractor/LicensiI Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The fo1r oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this-L�--day of ffIA,y1Fi , 2Ab by
this _ day of 20_ by
Tom Fite
Tom Fite
Name of person making statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Pro uced
Produced
IV- WAIMY
(Signatu of ota ublic-State of Florida)
(Si) ture oyrTotary blit-Sta of Florida )
Commission No. F 063105 (Seal)
Commission No. FF063105 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. L/ // 17
95 Ferrellgas
Doug Keip
Date: 5/5/2020
Account Manager
Cell # 772 216 2656 Fax # 5615751964
douskeic�jferrelleas.com EXPIRATION
N` I DATE: 30 Days
Customer Name: Kenaeth [,
Phone# 772 370 3582 email• donna.neyosduicesschools.org
CUSTOMER
ID# Site Address Contact Person
53665986 3407 Oleander Ave Ft Pierce FL 34982
Quantity Item Per Unit Cost
Amount
Exising gass stem install up to 10' of gas line
and conned new 16KW generator.
Generator being provided by Energize Electric.
$380.00
SU13-TOTAL
State Sales Tax 7%
Permit if applicable
TOTAL
$
V$786.60
The undersigned agrees therm the creat that h becntnes necceaarr to
Huge= any of the dorms and conditions of dds proposal, the undersigned
shag be responsible to Ferreggac LP for any and an anomey fixe and/or
weft incurred by Ferrcggae LP relating to the eofortxmem of this
proposaL To accept the quotation, sign here and serum.
[SEE OTHER TERMS OF PROPOSAL ON PAGE TWO] NGE 1 OF 2
Thank you for your business
Tank & appliance locations must comply with all state & local gas and building codes.
A SITE SURVEY IS TO RR SUPPLIFn HY THF fi ISTOMER FOR PERMITTING PURPOSE& TH EREIS A MINIMUM OF 4 TO a W EEKS
PERIOD NEEDED FOR PG•RMIT PROCESSING FROM THE DATE OF THF DF.POSIT & REQUIRED DOCUMENTS ARG RFCF.IVF.D)
PRIOR TO ANY WORK BEING PERFORMED ON SITE
• Revisions made after permitting will require an additional 3-6 weeks for processing& there will be additional chzrges.
Fermilgas is not responsible for damage to u/g pipes or lines (including irrigation, electric, etu) not marked by central
locating service. Homeowner is responsible to mark their own sprinkler or low voltage lines.
Ferrellgas is not responsible for placement or physical adjustment of appliances.
Ferrellgas is not responsible for damage to or replacement of landscaping.
Customer is responsible for providing conversion kit to convert any gas appliance for use of propane.
Generators are required to have a flexible line to connect to gas.
Customers credit must be approved prior to commencement of any work
Any sleeving, directional boring, excessive roots, or coral rock will require an addition charge.
Bonding of gas Iines Lo be done by others.
Underground tanks includes cathodic protection.
A 60% deposit Is due upon acceptance. A 10% cancellation penalty will apply,
Please sign if you have read & agree to the foregoing proposed contact & accept it.
The undersigned agrees that in the event that it becomes necessary to litigate any of the terms & conditions of this coatractt, that
the undersigned shall be responsible to Ferrellgas Lp for any & all attorney fees and/or costs incurred by Ferreligas LP
retaining to
the enforcement of this contract
Customer
Ferrellgas Signature D x' Date: 31-ze) Z J
Valid for 30 Days
Contact Information :
Penny Randall 561 746 4534 East 25104
Kim Wilkins 772 287 4330 Ext 22578
Jane Conner 772 287 4330 Ext 25101
Page 2 of 2