HomeMy WebLinkAboutFuel.Gas_Crist-Stefanakis_App-SignedContract-Sub-Contractor AgreementAll 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 Residential X
PERMITTYPE: LP Gas
PROPOSED IMPROVEMENT LOCATION:
Address: 4535 S INDIAN RIVER DR FORT PIERCE, FL 349tiZ
Property Tax ID #.. 2436-324-0003-000-1 Lot No. 2
site Plan Name: 2003-0642 CRIST CONSTRUCTION/STEFANAKIS RESIDENrMFKk No.
Project Name: CRIST/STEFANAKIS
I DETAILED DESCRIPTION OF WORK: I
INSTALL 250 UNDERGROUND LP TANK AND LINE TO RANGE, WH AND GENERATOR
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical XGasTank XGasPiping_Shutters _Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3313.90
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name GEORGE STEFANAKIS
Name: Tom Fite
Address: 797 SW HILLSBORO CIR
Company: FerrellQas
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No. 772-370.4024
E-Mail:limcrst@yahoo.com
Address: 3232 SE Dixie Hwy
City: Stuart State: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
Fill in fee simple Title Holder on next page ( If different
from the owner listed above)
E-Mail KlmWilklns@ferreligas.com
State or County License 31370
if value of construction is 5250o or more, a Kmumucu moxwc VI 4.Vnnncuwmc'�� m , cYru cv.
if value of HVAC Is $7,Soo or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 Home Owners Association bylaws
with any applicable rules, 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 YOUR PAYNG
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN OTTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEM "
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contrator/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
this6th day of October 2020 by
The forgoing instrument was acknowledged before me
this 6th dayof October 202Q by
Tom Fite
Tom Fite
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification _
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produ ed
Produced
(Signature of Notary bli
Commission No. FF E6
KIMBERLEY L. WILKINS
- ,= MS4NI,IMISSK)N#FF063I0
nature of Not
mission No.
NS
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MYPIRES IN ',F1 F063105
= 5
EXPIRLS:Nove;-ber28,2021
iCgsF B ad
XPIRcS.N a 28, 2027
"<�FF�o": Bonded TNu Notary Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
r Ferrellgas
w Omer
ID
Crist Construction Cc
4365 Galm Trace Lane
Ft Pierce FL 34952
Ilmtxal®yahelLM
Jim Gist 772 370 4024
To Install:
DougKelp
AccouunttManan
ger
T72 216-2656 cell 772 287-3456 fax
douakelof211xnloa
Date: 6-Fob-20
LEASE 250 Gallon UG LP Tank
George Stefanakis
S Indian River Or
R fierce fL U982
Lease and Inetsllation of 250 gallon underground LP tank and new gee line to 3 outlets
250
Gallon Propane Tank
UG
Installation
ExL Line
up to 125' of 922 piping
Ind Line
up to 00' of ties piping
Fxar F1X al N J• a p W) aNbn
Final Connect and 3 outlet
Regulators
Sub Total
Tax
Permit
TOTAL
$ 125.00 am,w rw
$ 750.00 'bvarw.
$ 1,250.00 •gmlmwn dflgp.W WURbn.l pa romh
$ 375.00
$ 270.00
$
2.770.00
7.00% $
193.90
$
350,00
$
3,313.90
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Salary Ce.c and SMTW
Repulalua, SFulroH Vahva, Riser., e[c.
oddYonal.ho,YwRy
e.roncabie
$ 10.00
$ 1450
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d.00eh aPmob.ed«Pemr.r aanNedlplPrrq Wan here" m toon Wra
• ReNeiona mean elW Oe,nilOkp Marepuieen W9tlPel ya WMMa IP PrctlYlnp bNPa MllbpdatleW CIPpY.
Fal.Nlgas is not rnpoTlWlab damapan Ixp pas r anp IImeN4610 Mlaaaa, elea4i wal mot mrw a1' ordral IRvtbp eeMu. NlaneavnP k reepPWide to
mangW wn apdnMr w kw waMesaers
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Customer Signature; Date: v Al
Fenellgas Signature Date: 09/16/2020
wild FP w W"
Contact Information
Penny Randall 551 746 4534 Ext 25104
Kim Wilkins 772 287 4330 Ext 22578
Jane Conner 772 287 4330 Ext 25101
3232 SE Dixie Highway. Shmn FL 34997
PERMIT# 1 2003-0642
ISSUE DATE
PLANNING & DEVELOPMENT SERVICES
Building & Code Compliance Division
BUILDING PERMIT
SUB -CONTRACTOR AGREEMENT
FERRELLGAS have agreed to be
(Company Nalne/Individtml Name) g
the LP GAS Sub -contractor for Crist Construction Co.
(Type o 'Trade) (,Primary Contractor)
For the project located at 2436-324-0003-000/1
(Project Street Address or Property Tax ID #)
It is understood that, if there is any change of status regarding our participation with the above mentioned
project, the Building and Code Regulation Division of St. Lucie County will be advised pursuant to the
filing of a Change of Sub -contractor notice.
CONTRACTOR SIGNATURE (Qualifier) SUB -CONTRA OR SIGNATURE (Qualifier)
PRINT NAME
COUNTY CERTIFICATION NUMBER
State of Florida, County of
The foregoing instrument was signed before me this _ day of
.20_, by
who Is personally known _or has Produced ■
as idenfificanon.
5 goatnre of Notary Public STAMP
Print Name of Notary Public
Revised 11/16/2016
TOM FITE
PRINT NAME
31370
COUNTY CERTIFICATION NUMBER
State of Florida, County of MARTI N
The foregoing Instrument "a signed before me thin 13TH day of
MAY 20_ by TOM FITE
who is Personally known _or
Kimberley L. Wilkins
Print Name of Notary Public
ama
ERLEYL. 4YILKtNSMISS10NPFF083f05: ver•ber28, 202rNo Notary PoWb UrMe,wnten
i
STAMP