HomeMy WebLinkAboutFuel Gas.LONG-2635 S Brocksmith Rd_App & Signed ContractAll 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 34981
Phone: (772)462.1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: LP GAS
PROPOSED IMPROVEMENT LOCATION:
2635 S BROCKSMITH RD. FORT PIERCE FL 34945
Property Tax ID #: 2320-501-0034-000-4 Lot No.
Site Plan Name: WALLACE AND LISA LONG Block No. 3
Project Name:
I DETAILED DESCRIPTION OF WORK:
Install 500 gal ug tank and line to wh range grill and generator.
CONSTRUCTION INFORMATION: 1
Additional work to be performed under this permit— check all that apply:
_Mechanical XGasTank XGasPiping_Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 5710.70
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
O W N ERAESSEE:
CONTRACTOR:
Name Wallace Long
Name: Tom Fite
Address: 8133 Saratoga Way
Company: Ferrellgas
city: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 772-370-1858
Address: 3232 SE Dixie Hwy
City: Stuart state: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-mail: IisarobinsonlongCabgmail. com
Fill in fee simple Title Holder on next page I if different
from the owner listed above)
E-mail KimWllkins@ferrellgas.com
State or County License 31370
IT value or construction is p[Duu or more, a KtLURUEU Notice or commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNE ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State: _
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 Countv makes no representation that is granting a permit will authorize the permit holder to build the subject structure
in
which is 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
"WARNIING 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 AMD
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR ANA ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCE "
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 20th day of JUIY . 2020 by
this 20th day of July , 202Q 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
Produced
Produced
(Signature of Nota Publ'
ignature of No[ary I , I IBERLEY L. WILKINS
�.^VXI... KIMBERLEY L. WILKINS
Commission No. FF06 f1b P M(sm"MISSION#FF 063105
° °�: My w SSION#FF 063105
mmissionNo. FF 63 �� =
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-r.o,.' EXPIRE& Nover,bar 26, 2021
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Underwit
s
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
105 Ferrellons
Keip
Account Manager
772 2162656 call 772 287-3456 fax
douake1ptU11Qas,Wm
us omer
ID
Date: 19 -Ma -20
Csa L ng
2635 S. arodramith Rd purchase 500 Gallon UG LP Tank
Ft Pierce FL 34945
fialigibimanlaraftorULCOLD
Phone 772 3701858
To Install:
Sale and Installation of 500 gallon undo rground LP tank and gee line to water heater, range, grill antl ypnerator.
500 Gallon Propane Tank
UG Installation
ExL Line up to 40' of gas piping
Int Line up to 60' of gas piping
Find FIN ® $1n x (400) esPw
Final Connect and 4 outlets
Regulator:
Sub Total
Tax
Pe"it
TOTAL
$ 2,150.00 a wMprsysmm
$ 850.00 ro,mnaen
$ 400.00 •Wamumpl$3NNAeedd4ionapmiw10 $ 10.00
$ 750.00 •Wnimum AtAsa.W addaavlpNbn[® $ 12.50
(N]Sl.epf Tobe billed sepanrery. AaaNmna
mra s..eulna r.ee ndpnr appry.
$
500.00
$
350.00
$
5,010.00
7.00% $
350.70
$
350.00
$
5,710.70
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Contact Information
Penny Randall 561 746 4534 Ext 25104
Kim Wilkins 772 287 4330 Ext 22578
Jane Cornier 772 287 4330 Ext 25101