HomeMy WebLinkAboutPatten gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
IS51rp C��1C�DC
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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PERMIT APPLICATION FOR: GAS LINE
PROPOSED IMPROVEMENT LOCATION:
Address: 7350 Reserve Creek DR Port St Lucie, FL 34986
Property Tax ID #: 3322-601-0041-000-2
Site Plan Name: Patten generator
Lot No. 21
Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
install 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 _ Windows/Coors
_Electric _Plumbing _Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1195.00 Utilities: —Sewer _ Septic Building
Pond
Pitch
Height:
OWNER/LESSEE:
CONTRACTOR:
NameCarolyn Patten
Name: ((1A2SfNr
Company: Energized Electric
Address:4252 Bandy Blvd
City: Ft Pierce
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Address: 7350 Reserve Creek Dr
City: Port ST Lucie State: _
Zip Code: 34986 Fax:
Phone No. 7724656581
E-Mail:
State: FL
Zip Code: 34981 Fax
Phone No 7724661095
E-Mail energizedgenerators@gmai.com
State or County License LQ31756
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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:
i
DESIGNER/ENGINEER: — Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Address: _
City:
_ Not Applicable
Address:
City: State:
Zip: Phone
State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:_ Not Applicable
Name:
Address:
BONDING COMPANY:
Name:
Address:
City:
Not Applicable
City:
Zip: Phone:
Zip: Phone:
vvv1YCK/ 'k,UIv 1 KAI, I UK HI-FiDVI I : Application is hereby made to obtain a permit to do the work �nd 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 byild 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 hich 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 i ion -residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in pa ing twice for
improvements to your property. A Notice of Commencement must be recorded in he public records of St.
Lucie County and posted on the jobsite before the first inspection. If you inten o c btain financing, consult
with lender or an attorney before commencing work or recording your )kotic of Commencement.
Signature of Owner/
Agent for Owner I Signature ofttract r/License
STATE OF FLORI t STATE OF FLORIDA
COUNTY OF SV -COUNTY OF
rn to (or affirmed) and subscribed before me of S or o (or affirmed) and subscribe before me of
�1�hpical Pre c or Onlil�e Notarization hysical Presence or Onl ne Notarization
thiday of i1` 2020 by this f clay of 2020 by
Name of person making statement. Name of person making statement.
Personally Known /OR Produced Identification Personally Known n><- OR Produ ed Identification
Type of Identification Type of Identification
Pirouced Produced ,a
(Signatur j�q.��ry Publj§p'` I (Signa)ure of:1>istary Pate of lorrda )
2 _ MY COMMISSION # GG 23 948 ; �G ;,.
V
•1, ; i Z F; MYCOMMI . 6 �. tJ i 2329.`6
Commissi ado 'k PIRES:June27,(k li 7 202' (Se
tffidenwh Comm, s�Qi� Ii � EXPIRC ]. �3
Not Public nde letsr `#
SondedTt;� _ `:; on ru' ..tJ- ti;� ndonti isrs'
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TI J RTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
R, G I " � Z�'
Rf
EL - - E -i --i Q7 - T C j
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*Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pierce, FL, 34981, Fa
Palm Beach 561-752-0214, 1550 Latham Rd, Suite 3, West Palm Beach,
Proposal / Agreement
Carolyn Patten
7350 Reserve Creek Dr
Port Saint Lucie, FL 34986
772-465-6581
" e t - L"
1) Supply and install underground gas line to generator and fin
2) Price includes all labor, material and permits
3) Remove (1) square block for underground run
772-318-6672*
FL, 33409*
July 15, 2020
0 connect
or the sum of: $1,1�00
1786 SW Biltmore St, Port ST Lucie, FL, 34984 *Licensed & Insured FL
Toll Free 855-PROGAS4 *Treasure Coast 772-777-8133 *Palm Beach 561-752-0214
1747
Fax 772-318-6673
TERMS:
Charges & Payments. Charges are due in full at time services are rendered unless otherwise st ted 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/Contra 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
I, d (printed name), autho�ize Energized Gas to
complete the work in accordance with the above specifications and conditions. agree to pay as per
terms outlined above.
Signature
Date
This agreement shall be construed under the laws of the State of Florida. This agreement contains the E
parties and supersedes all previous verbal or written agreements: there are no other agreements, repro
set forth herein. If any conflicts exist in this agreement between terms which are printed and those whi
typed or written language shall govern.
re understanding of the
ntations or warranties not
are typed or written, the
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CONTRACT TERMS AND CONDITIONS
Installation will comply with all local and state regulations and be consistent with
ndard industry code.
Installer is not responsible for landscaping repairs as a result of installation*. This ncludes but is not
limited to; damaged/broken sprinkler lines and/or damaged/broken water or sewe lines.
This contract price does NOT include bonding gas lines, converting outlets, convertjng appliances or
carbon monoxide detectors II
Additional charges may apply if rock and/or roots are encountered during the exca ation 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
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
along with this signed proposal.
*To include sod replacement a charge of $395 applies.
CUSTOMER SIGNATURE FOR ACKNOWLEDGMENT OF
M L 1 1D i
PRINTED WAME
SIGNATUR
meowner if a tank tie
and can be submitted
DATE
TERMS
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