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:Lp tank and line
PROPOSED IMPROVEMENT LOCATION:
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Residential
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Property Tax ID #: 1423-602-0002-000-4
Lot No.2
Site Plan Name: Block No. 25
Project Name: Levan Gas
[DETAILED DESCRIPTION OF WORK:
Supply and install 500 gallon Ip tank with gas line to generator
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/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ ° I t Utilities: _ Sewer _ Septic Building Height:
OWN ER/LESSEE:
Name Sharon LeVan
Address:13 Sovereign Way
City: Hutchinson Island FI 34949 State: _
Zip Code: 34949 Fax:
Phone No. 772-579-9353
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
f value of construction is 25nn nr mnrc n DCw1DnCn _i
CONTRACTOR:
Name: Michael Flaxman
Company: Energized Electric
Address:4252 Bandy Blvd
City: Fort Pierce State: FI
Zip Code: 34981 Fax: 772-318-6672
Phone No
E-Mail
State or County LicenseLQ31756
------------ •-......., v. �.v.nncn6Clllefll IS requirea.
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-resjdential 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 post d on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an att ney before commencing work or recording your NQtice of Commencement.
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Signature of , w er/ L -see/Contractor as Agent for Owner Signatur pf Co - actor/License Holder
STATE OF FLORIDA� ` - STATE OF FLORIDA
COUNTY OF COUNTYOF
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
`Physical Presence or Online Notarization cal Presence or Online Notarization
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this-Ig 1 2020 by this � of� , �� . 2020 by
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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
Produced Produced
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EXPIRES: June 27, 2Q22 S I )
�> c EXPIRE S: June 27, 2022 Bonded Thro Notary Public Undenuters
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
Proposal / Agreement
Sharon Levan
13 Sovereign Way
Fort Pierce, FL 34949
772-579-9353
J�Nf et
6672*
August 17, 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
or the sum of: $49295-001
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
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
Acceptance of Proposal
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.
m
Signature Date
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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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
PRINTED NAME
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SIGNATURE
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