HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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 Number:
Building Permit Application
Commercial Residential x
YtKM1T TYPE: LP TANK
PROPOSED IMPROVEMENT LOCATION:
Address: 1522 NW BLlTTQNBUSH CIR, PALM CITY, FL, 34990
Property Tax ID #: 4426-815-0072-000-7
Site Plan Name:
Project Name: Marshall gas
DETAILED DESCRIPTION OF WORK:
Install 500 gallon underground LP Tank with gas line to generator and final connect
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical _ Gas Tank _ Gas Piping Shutters
— Electric — Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4295.00
OWNER/LESSEE:
Name William Marshall JR
Lot No.
Block No.
Windows/Doors
Sprinklers _ Generator i Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
Address: 1522 Buttonbush Cir
City: Palm City State:
Zip Code: 34990 Fax:
Phone No. 7722858915
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Manuel Tobar
Company: Thompson Gas
Address: 1786 SW Biltmore St
City: Port ST Lucie State: FL
Zip Code. 34984 Fax:
Phone Na 7727778133
E-Mail
State or County License Ur L4
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 LOW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
i
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ` Not Applicable
BONDING COMPANY: Nat Applicable
Name:
Name:
Address:
Address.
City:
City:
Zip: Phone:
Zip: Phone:
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wvv ivi.n1 LUN i ru-,.Li VR Arriuvi t : Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work a 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 a 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, 1 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."
Signature of Owner/ Lessee/Contractor as Agent far Owner
STATE OF FLORIDA
CO U NTY OF S7," l c'ae.
The forgoing instrument was acknowledged before me
this lC dayof acne- , 20 Ra by
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY
The forgoing instrument was acknowledged before me
this L%�_ day of 3'Unre. Zp .7 p by
— AtC'Lt_Ue t 7,0644- 1 an Tob r,r
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
[S' ature of Notary
Personally Known Y OR Produced Identification
Type of Identification
Produced
41---
b(Sieature of a of Florida_)
Notary PuNc State or Florida a+latary PtrWiC Stater Fro a Commission No. Jam Cowdeli ommission N . W CvwcteI�eF l
ARy Commission GG 73643�t My LW
GG 236434
of liras 07ffiarz 2Y at ram' E Om 07MW2M2
REVIEWS FRONT ZONING S=REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
f COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
COMPLETED
*Treasure Coast 772-466-1095. 4252 Bandy Blvd, Fart Pierce, FL, 34951, Fax 772-3I -6672*
*Palm Beach 561-752-0214, 1700 Latham Rd, Suite 2. West PaIrn Re:Ic•h Fr Ila a*
Proposal / Agreement
Bill Marshall
1522 NW Buttonbush Cir
Palm City, FL, 34990
772-285-8915
MarshallFWilliam mail.com
18th, 202❑
1) Thompson Gas to supply and install (1) customer owned 500 gallon
underground LP Tank with 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 line to be installed by Th rn son Gas
the sum
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
3 800.00 is due @ Com letion
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:
Roger Lussier
Acceptance of Proposal
1, l f 4,a C
complete the work in accordance with the
terms outlined above.
ignature
—(Printed name), authorize Energized Gas to
specifications and conditions. I agree to pay as per
Date
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.
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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 fines, converting outlets, converting appliances or
carbon monoxide detectors
Additional charges may apply if rock and/or roots are encountered during the excavation process.
I3eposit 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 can be submitted
along with this signed proposal.
*To include sod replacement a charge of $395 applies.
CUSTOMER SIGNATURE FOR ACKNOWLEDGMENT OF ABOVE TERMS
vtt—_C
PRINTED NAME
4_ L
SIATURE
0a eA
D TE
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