HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
4001)ftiaNA° - Building
Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:GeneratOr
PROPOSED IMPROVEMENT LOCATION:
Address: 8327 Muirfield WAY Port Saint Lucie, FL 34986
Property Tax ID#.. 3328-802-0010-000-1 Lot No.7
Site Plan Name: Block No.
Project Name: Seel gas
DETAILEQ DESCRIPTION OF WORK:
install gas line from existing tank to generator and final connect
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under thispermit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1195.00 Utilities: _Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Name:Michael Flaxman
Address:8327 Muirfield WAY Company:Energized Electric
City: Port ST Lucie State:_ Address:4252 Bandy Blvd
Zip Code: 34986 Fax: City: Ft Pierce State:FL
Phone No.5027413001 Zip Code: 34981 Fax:
E-Mail: Phone N07724661095
Fill in fee simple Title Holder on next page(if different E-Mail energizedgenerators@gmail.com
from the Owner listed above) 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:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
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:
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 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 before the first inspection. If you intend to obtain financing, consult
with lender or an attqrney before commencing work or recording our otce o-foCommencement.
Signatur�FFLORIM-A
f 0 ner/ essee/Contractor as Agent for Owner Signature o C ritracto License Holder
STATESTATE OF FLOR
COUNTY OF COUNTY OF _,AJ� .�.
S� �p
to(or affirmed)and subscribed before me of Swq .#o(or affirmed)and subscribed before me of
Physical Pre nce or Online Notarization Q Physical Pres c or Online Notarization
this day of 2020 by this 'A day of U�E2020 by
-( t aky _k n . T� I T_
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known \,— OR Produced Identification
Type of Identification Type of Identification
duce d Pro d
Si nature of No r �sUf e,-Stat I LOBd�i)iCALVES YP�'
g Ko..:. c.' (Signature of Notar R ate o°i aONCALVES
MY COMMISSION#GG 232946 _ ;
* MY COMMISSION#GG 232946
Commission No. *-
EXPIRES:(.f 947,2022 Commission No. =' ,° EXPIR,...:.. E5� �7 2022
qK Bonded Thru Notary Public Underwriters onded Thru Nota
ry Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5
M le 1
*Treasure Coast 772-466-1095,4252 Bandy Blvd,Fort Pierce,FL,34981,Fax 772-318-6672*
*Palm Beach 561-752-0214, 1550 Latham Rd,Suite 3,West Palm Beach,FL,33409*
Proposal / Agreement
Tom Seel July 9, 2020
8327 Muirfield Way
Port Saint Lucie, FL 34986
502-741-3001
Tom@SeelGroup.com
1) Supply and install underground gas line to generator and final connect
2) Price includes all labor, material and permits
NOTE: Gas line to be installed by Thompson Gas
F-the sum of.- $.1
1786 SW Biltmore St, Port ST Lucie, FL, 34984*Licensed &Insured FL34747
Toll Free 855-PROGAS4*Treasure Coast 772-777-8133 *Palm Beach 561-752-0214*Fax 772-318-6673
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
$700.00 is due @ Completion
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 Gas to
complete the work in accordance with the above specifications and conditions. I agree to pay as per
terms outlined above. kLek Date '7 l Zed Zo
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.
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