HomeMy WebLinkAboutBuilding permit appAll 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) 462-1578
Commercial
PERMIT APPLICATION FOR:GENERATOR
PROPOSED IMPROVEMENT LOCATION:
Address: aouo esaisam ur, ror[ Nierce, F-L, 34982
Property Tax I D #: 3402-610-0340-000-1
Site Plan Name:
Project Name: Weinberg gas
DETAILED DESCRIPTION OF WORK:
install 500 gallon underground gas tank with line to generator and final connect
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be per •ormed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4295
Sq. Ft. of First Floor:
Residential X
Lot No.14 & 15
Block No. 81
Windows/Doors Pond
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Mark Weinberg
Name: Michael Flaxman
Address:5803 Balsam Dr
Company: Energized Electric
City: Ft Pierce State: _
Zip Code: 34981 Fax:
Phone No.
Address:4252 Bandy Blvd
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone No7724661095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
it _i
E-Mail energizedgenerators@gmail.com
State or County License LQ31756
�••- •11 - a nr%.vnuru rvoiuce 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:
DESIGNER/ENGINEER: _Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 efore the first inspection. If you intend to ob financing, consult
with lender or an attorneybefore co encin work or recordin our Notic of C mencement.
Signature of Owner/ Lessee Co tractor s Agent for Owner
Signature of r ctor/License Holder
STATE OF FLORID -, _
COUNTY OF�my'
STATE OF /L001RI
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
— V (-/a k' in P V1 I b "mi ri G,/,)
Sw to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 12020 by
o
Na e of person making statement.
—widnn
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
gs
Personally Known `°�. OR Produced Identification
Type of Identification
Pro ced_
roduced
(Signatur of; K Publjgq
MY COMMISSION # GG 232946
Commissi �I i S June27,*00
">r•...• a;
-.f.... .. •' Bonded Thru Notary Public Underwriters
— - --
(Signatu o ,. y��ry Pint alt@ )
= ��'' ° `= MY COMMISSION # GG 232946
Commissi °''' '� •June27,2oW2eal)
^.',rE •. • • �?:'
? ��.• Bonded Thru Notary Public Underwriters
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
*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
Mark Weinberg
5803 Balsam Dr
Port Saint Lucie, FL 34982
772-201-0264
Markw119(a)mac.com
August 20, 2020
1) Supply and install (1) customer owned 500 gallon underground LP tank with
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
0
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
$3,800.00 is due @ Generator startup
vve 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
Acceptance of Proposal
Mark Weinberg
I, (printed name), authorize Energized Electric
to complete the work in accordance with the above specifications and conditions. I agree to pay as per
terms outlined above.
Date August 20, 2020
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.
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
Mark Weinberg
PR NTED NAME
7
SIGNATURE
August 20, 2020
DATE
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