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HomeMy WebLinkAboutRIley 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) 462-1553 Fax. (772) 452-1578 Commercial mercial PERMIT APPLICATION FOR: Gas PROPOSED IMPROVEMENT LOCATION: Address: 5340 Dunn Rd Fort Pierce, FL 34981 Property Tax ID #: 3403-502-0209-100-3 Site Pian fume: Project Name: Dan Riley Gas DETAILED DESCRIPTION OF WORK: � f' New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Residential x Lest No. Block No. Additional work to be performed under this hermit– check all that apply. Mechanical Gas Tank � Gas Piping `Shutters Windows/floors Pond Electric ' Plumbing _ Sprinklers — Generator ` Roof ` pitch Total Sq. Ft of Construction: Cost of Construction: $ 895.00 OWN ERAESSEE: Name Dan Riney Address: 5340 Dunn Rd Sq. Ft. of First Floor: Utilities: _Sewer Septic Building Height: City: Fort Pierce Stater Zip Code. 34981 Fax: Phone No. 7725211416 E -Mail: Dan@AMTFL.com AMTFL.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name.Michael Flaxman Company: Energized Electric Address:4252 Dandy Blvd City: Fort pierce State: FI Zip Code: 34981 Fax: Phone No 772-466-1095 E -Mail energizedgenerators@gmail.com State or County License LQ31756 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: VEGETATION REVIEW ESIGNER�ENGfNEER: Nat Applicable MORTGAGE COMPANY: Not Applicable me: [Address: Name: Address:y: City: State: 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: OWNER/ rnNTRArTn12 AccinwnT. ___ _ __ . _ .._ —' ,-- I , , �E fJ„LdLIU[I is hereby mane to 00tain a permit to do the work and installation as indicated. I certify that no work a instaiiation 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 pasted on the jobsite before the first inspection. If you intend to obt financing, consult with lender or an attorne efore commencing,work or recordingour Notice of �encement, Signature of O) neK/ Les�ee/Contractor as Agent for Owner +Signature of ntractor/License Holder STATE OF FLORI STATE OF FLORIDA COUNTY OF I I COUNTY OF StLck__� Sworn to (or affirmed) and subscribed before me of ei sical Pres ce or, online Notarization thisday of ' ( 2020 by nr I I Name of person making statement. Personally Known A— OR Produced Identification Type of Identification fr*7'_V§..,F_F”! *MYCOMMISSION#GG23294Cam >=Y{Se Fended Thru Notary PuMc Underwriters REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED SW,Qla-to (or affirmed) and subscribed before me of sical Pres nce or Online Notarization thi 'day of 2020 by 11� Lul Name of person making statement. Personally Known --, OR Produced Identification Type of Identification Produced DANIELLE GONCAMS Cam h'yc0MMISSI0N # GG 232W (eel } , A PA S: June 27, 2{}22 if 1301"ded Thrll nafa-Anf.l:n I I...a_..­.. SUPERVISOR J PLR REVIEW j REVIE - NS W VEGETATION REVIEW nnlwll SEA TURTLE REVIEW MANGROVE REVIEW ,i `Treasure Coast 772-466-1095., 4252 Banc{ - Blvd. Fort Pie€ ec, FL, 34981, Fax 772-3 1 S-6672* :k Palin Beach 561-752-0214. 1550 Latham Rd. Suite 3, West Palm Beach- FL, 33449* Proposal / Agreement Dan Riley 5340 Dunn Rd Fort Pierce, FL 34981 772-521-1416 Dan(dAMTFL.com June 30, 2020 1) Supply and install aboveground gas line to generator and final connect 2) Price includes all labor, material and permits NOTE: Gas line to be installed by Thompson Gas or the sum o : $89 . o0 1786 SW Biltmore St, Port ST Lucie, FL, 34984 *Licensed & Insured FL34747 Toll Free 855-PROGAS4 *Treasure Coast 772-777-8133 *Palm Beach 561-752-01214 *Fax 772-318-5673 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 $447.50 is due @ Gas Line Installation $447.50 is due @ Completions 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: -, Brian Orr Acce Lance of Pro osa[ (printed name), authorize Energized complete t e work in accordance with e above specifications and conditions. I agree to a as per e© terms outlined above. P p R r 1 DateC1 Signature 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. Page 2 of 2 CONTRACT TERMS AND CONDITIONS installation will comply with all local and state regulations and be consistent with standard industry code. Installer 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 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 Z al PRINTE15 NAME e r SIGMA URE 2011� DATE Page 2 of 2