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Home My WebLink AboutLAshorne gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: P L Il it 1, tt .�•��,..� Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FORIP TANK PROPOSED IMPROVEMENT LOCATION: Address: 5505 PALED PINES CIR, FT PIERCE, FL, 34951 Property Tax ID #t: 131250000060008 Site Plan Name: Project Name: Lashome tank DETAILED DESCRIPTION OF WORK: install 500 gallon underground LP tank with gas line to generator and final connect New Electrical Meter Second Electrical Meter Residential x Lot No. 5 Slack No. CONSTRUCTION INFORMATION: � Additional work to be performed under this permit— check all that apply: Mechanical "� Gas Tank — Gas Piping — Shutters Windows/Doors Pond Electric _ Plumbing — Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Cost of Construction: $ 4595.00 Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR- NameJefFrey Lashome Name: Address:5545 Paleo Pines Cir Company: Si City: Ft Pierce Stater Zip Code: 34951 Fax: Phone No.7722931131 Address:1786 SW Bit mare 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 !! �� State or County License U.� S rN I- If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC 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: City: State: Zip: Phone. -- Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Add ress: City: Address: City: Zip: Phone. Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worst 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County 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 recordine�ur Notice of Commencement_ Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF s-1Luc; e_ COUNTY OF ¢ 4u cd e Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of APhysical Presence or Online Notarization Physical Presence or Online Notarization this 1& day of 3u n e— 12020 by this 4_ day of _ Zry ft e 2020 by ILA!wV I --ro]oa.r- 1Ni�nuL 6 _. Name of person making statement. _ Name of person making statement. Personally Known OR Produced Identification Personally Known X OR Produced Identification Type of Identification Type of Identification Produced Produced (Sig ture of N❑ (Si ature of No Notary POW State of Florida � Notary Public State o::F1o]dda Commission 1vo. J� w CrN"ow Commission No. � � 00Mrr� ;M Explres 071)9=2 qr E*Lw 07MW2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20 *Treasure Coast 772-466-1095, 4252 Bandy Blvd. tort Pierce, VI„ 34981. 1,ax 772- 19-6672* *Palm Beacli 561-75?-0? 14, 1700 Lathani Rd. Suit: ?, West Palen Beach. FI_. 33 09* Proposal / Agreement Jeffrey Lashorne 5So5 P I P' c' May 13th, 2020 a eo Ines it Ft Pierce, FL, 34951 772-293-1131 JLashorne@bellsouth.net 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 backfilling and removing dirt 4) Price does NOT include filling the tank with propane NOTE: Tank and fine to be installed by Thompson Gas IFor the sum. of 8'd. j7Q5. od 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 sate 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 $4 100.00 is clue @ Generator startup We appreciate the opportunity you have extended us to quote on this work and would like to thank you in advance for our consideration. Authorized signature: Brian err Acceptance_ -of Proposal I, tar h 2. (printed name), authorize Energized Gas to comp to the work iA accordance with the above specifications and conditions. I agree to pay as per term¢ niitlinpri ahnvP- Date _ U S - ] � •.Ib - 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 ped or written, the typed or written language shall govern. fy Page 2 of 2 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 process 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 cpn 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 §1414JkTORE c)S - ,if -av DATE Page 2 of 2