HomeMy WebLinkAboutBurkhead signed contract, appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone; (772) 452-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: )"6� ,, AV&
Property Tax ID #:
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
New Electrical Meter
Jvc
Porgy -S�- Luc,'
Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No, —
Block No.
Additional work to be performed under this permit — check al I that apply:
_Mechanical Gas Tank I Gas Piping
_Shutters ^ Windows/Doors ` Pond
Electric ` Plumbing Sprinklers
_ Generator _ Roof Pitch
Total Sq. Ft of Construction;
5q. Ft. of First Floor;
ccy
Cost of Construction. $ Utilities:
_ Sewer T Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
Name o-N:
Name:1 A/ c5 ir
Address: 1 "57
Company:
City: PUf' e-, a State: A
Address: 17iL 6 ,1
Zip Code: �,� Fax:
City: Exi: <'4_ _ [LL'c"'z- Stater
Phone No,
Zip Code: Fax:
Fax:
E-Mail:
phone No
Fill in fee simple Title Holder on next page [ if different
E-Mail
from the Owner listed above)
-State or County License
v...v.. f u—n." 15 Za v Vf fFlore, a RECORDED Notke or Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ER�ENGINEER: Nat Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City.
Zip: Phone:
Zip: Phone.
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wvv,rL-n,f wir i n► %-1 Un ►arriuvi r : 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 confIIct 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 fallowing 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 leader or an to rn ey before co m me nci ng work or recordin our Notice of Commencement.
Signature of Owners Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ZflCr Q, COUNTY OF
Sworn to (or affirmed) and subscribed before me of 5w rn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization ,Physical Presence or Online Notarization
this � day of � yc-% e-.. , 2020 by this -/!day of �)S z-e 2020.by
i &Avel cb&r unve� a rx
Name of person making statement. Name of person making statement.
Personally Known Y OR Produced Identification
Type of Identification
Produced
{ ' nature of Notary Public- Nat" Public Ste*
�l ^ W ll Flalitk
Commission IVo. {y�'GG234
... Expires 07/0 =22
REVIEWS I FRONT I ZONING
j COUNTER j REVIEW
DATE
RECEIVED
DATE
COMPLETED
Personally Known X OR Produced Identification
`type of Identification
Produced _
SUPERVISOR I F
REVIEW RI
re of Notary Pu 'c6ftf�W `cow u r""""
ion No. MY Corrwision GG 2364M
'LANS
VEGETATION
SEA TURTLE
MANGROVE
=VIEW
REVIEW
REVIEW
REVIEW
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Energized Gas Inc
Fropawand Arak sal o4o spaakzPw
Proposal / Agreement
Daniel Burkhead
185 SE Sandia d r
Port St Lucie, Florida 34953
04/ 17/20
Energized Gas hereby agrees to furnish all labor and materials necessary for the completion of
services as spee:ified below;
1. Supply and install gas line from meter to stove
2. Price includes labor, material, permitting and drawings
3• I n in I r r
For the sum of: $685. oo
1785 SW Biltmore St., Part Saint Lucie, FL, 34984 *Licensed & Insured FL34747
Toll Free 855-PROGA54 *Treasure Coast 772-777-8133 *Palm Beach 561-752-0214 *Fax 772-318-5573
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 chargeslfees. Proposa VCo ntra ct pricing good for 30 days from Pro pas a I/ Contract date
$685.0O due at install
We appreciate the opportunity you have extended us to quote on this work and would
like to thank you in advance for your consideration.
Authorizers signature:
Joseph Giancontieri
ACceptance of Pro osa I
I Daniel Burkhead
(printed name), authorize Energized Gas to
complete the work lrraccQrclance wig tie above specifications conditions. I agree to pay as per
terms outlined above\ 1
Camel Burklie ad (Apr 20, 2020
Signature
April 20, 2020
Thank you for choosing Energized Gas Inc
"Serving the East Coast of Florida"
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.
CONTRACT TERMS AND CONDITIONS
Wage 2 of 3
Installation will comply with all local and state regulations and be consistent with standard industry code.
Energized Gas, Inc. is 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 Unless otherwise stated above
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. Energized Gas, Inc. is not responsible For
customers failing to obtain final approval.
If home is located in a flood zone, the additional cost will be the responsibility of the homeowner if a tank
tle 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
Danie[ Burkhead
PRINTED NAME
eG k e
Oark'e1 Burkhead (Apr 20, 20201
SIGNATURE
April 20, 2020
DATE
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