HomeMy WebLinkAboutSeaman gas app, 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 34982
Phone: (772) 452-1553 Fax: (772) 452-1578
Commercial Residential X
PERMIT APPLICATION FOR: Gas tank
PROPOSED IMPROVEMENT LOCATION:
Address: 10300 inverness Way, Port ST Lucie, FL, 3498E
Property Tax I D #: 3321-802-0022-000-7
Site Pian Name:
Project Name. Seaman gas
DETAILED DESCRIPTION OF WORK:
Install 500 gallon underground LP Tank with gas line to generator and final connect
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
Mechanical Gas Tank _ Gas Piping Shutters
Electric — Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cast of Construction: $ 4800.00
Sq. Ft. of First Floor:
Lot No. 16
RMTR A
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: -
NameTheodora Seaman
Address:25 Daniels Way
City: Day Shore State:
Zip Code: 11706 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: I`ll[[.I1fJxy �►CJ� 'v`]
Company- � l
Address: ^ 1v
City:N FI
State:
Zip Code: _M4 Fax:
Phone No
E -Mail r�'
State or County License
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:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
❑WNFR/ r nPJTRAr'TnD Aemm1111r. r _._ .. _ .•
Zip: Phone:
---- .... ._ ...... , ,.r Y, , , .,NN„s LdUU11 ,riereby 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 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 bgfore the first inspection. If you intend toain financing, consult
with lender or an attorney before
co rising work or recording yourkotice o mmencement.
Signature of
as Nent for Owner I Signature of
Holder
STATE OF FLORI�
STATE OF FLORID
COUNTY OF l COUNTY OF
S orn to (or affirmed) and subscribed before me of
sisal Pres ce or Online Notarization
this tday of 2620 by
Name of person making statement
Personally Known
Type of identification
of
Commission
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
OR Produced Identification
S to (or affirmed) and subscribed before me of
theP_ sisal Pres ce or Online Notarization
day of 2020 by
Name of person making statement.
Personally Known '�K_ OR Produced Identification
Type of Identification
Produced
F*�ILT1i111+1 it 4T7 n"12MM t•�IsI IP LLII C l.i_T - {*,gy't'u/ `,.+
'SSION
�y►y y�
YP a= Commissio `,.' EXPIRES:Ju►ria27, 7a
W1ded ihru Nafary PubAo tlnderwsifera
FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
*Treasure Coast 772-466-1095. 4252 Bandy Blvd, Fort Pierce, FL.. 34981, Fax 772-318-6672*
*Palm Beach 561-752-0214, 1700 Lathaan Rd, Suite 2, West Palm Beach, FL, 334(]9*
Proposal / Agreement
Gordon Seaman
10300 Inverness Way
Port Saint Lucie, FL 34986
772-4655-7486
June 9, 2020
1) Thompson Gas to supply and install (1) customer owned 500 gallon
underground LP tank with underground boring for 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 Thom son Gas
ror the sum 1 $4,800-00
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
4 305.00 is due @ Generator start-up
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
(printed name), authorize Energized g Gas to
complete the work in accordance with the above specifications and conditions. T agree to pay as per
terms outlined above.
Date Z
nature
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 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 can 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
F
SIGNATURE
V - "
DATE
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