HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Perrr it Number:
�IrLUCE
O
o ° p 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:GAS TANK
PROPOSED IMPROVEMENT LOCATION:
Address: 64 Mediterranean Blvd E Port Saint Lucie, FL 34952
Property Tax I D#: 3426-500-0943-000-4 Lot No.
Site Plan Name: Block No. 1 &2
Project Name: Albano gas
DETAILED DESCRIPTION OF WORK:
Install 500 gallon underground gas tank with 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 _Generato _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3795.00 Utilities: —Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameSuzieAlbano Name-.MichaelFlaxman
Address:64 Mediterranean Blvd E Company:Energized Electric
City: Port ST Lucie State:_ Address:4252 Bandy Blvd
Zip Code: 34952 Fax: City: Fort Pierce State:FL
Phone No.6093493432 Zip Code: 3498 Fax:
E-Mail: Phone No7724 61095
Fill in fee simple Title Holder on next page(if different E-Mail energize generators@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 OMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING C MPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a p rmit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a perm t.
St. Lucie County makes no representation that is granting a permit will authorize th permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or a d covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your dee 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 Cou ty Amendments.
The following building permit applications are exempt from undergoing a full concu rency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and access ry uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commenceme t may result in paying twice for
improvements to your property. A Notice of Commencement mu t be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain fi Ancing, consult
with lender or an attornev,.befoWcommencing work or recording our Noticg ofCommqncement.
Signature of Owner/ ss e/C ntractor as Agent for Owner Signature of o actor/Licen Holder
STATE OF FLORIDA STATE OF FL I
COUNTY OF5 A__' a', .: COUNTY OFR C
Sw r-to(or affirmed)and subscribed before me of �-�9Ph�sical
o(or affi med)and subscribed before me of
,, Physical Presence or Online Notarization Pr Bence or Online Notarization
this�� day of JL1C�tfYI — 2020 by t,')i day of 2020 by
Name of person making statement. Name of person aking statement.
Personally Known OR Produced Identification Personally Know OR Produced Identification
Type of Identification Type of Identification
Produced 1 Produce
(Signature o N a'"'l lj + t uldfIrl �$e} (Signaturei'fiNP __Publi jjKofQoridtE; L
-* o Xi�iE'�a J�r {?� _ *: My COMMISSION it GG 232946
o ��r1ir�
Commission c5'TF �aQ' aUndOdThruri0tcrdt xR Commissio _ " :JUt)e'l.l, (iS^�al)
, is<
Bonded ThruPdotaryl'ub'ic,Usul swn+ars
REVIEWS FRONT ZONING SUPERVISOR PLANS VEG TATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW RE IEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Ke—v—.576/20
1 �
�r-
*Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pier e, FL, 34981, Fax 772-31 -
72*
*Palm Beach 561-752-0214, 1700 Latham Rd, Suite 2, est Patin Beach, FL, 33409*
Proposal / Agreement
Suzie Albano
64 Mediterranean Boulevard East September 23, 2020
Port St. Lucie, FL 34952
609-349-3432
vworld7@juno.com
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
For the sunt of.- $35,795.00
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 ees 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 fromProposal/Contract date
$495.00 is due @ Signing
$3,300.00 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:
Brian Orr
Acceptance of Proposal
I UJ t VJCR'k Z SPsw II c�
� � �t � � —(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,.
Date
signature
This agreement shall be construed under the laws of the State of Florida. This agree ent 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 pri ited and those which are typed or written, the
typed or written language shall gover .
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