HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit
Number:
1�ir
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Q
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 -rank
PROPOSED IMPROVEMENT LOCATION:
Address: 5211 EAGLE DR - Ft. Pierce, FL
Property Tax ID #: 1312-801-0065-000-3
262
Lot No.
Site Plan Name: 5211 EAGLE DR
Block No. HASE II-B
Project Name: Joseph F RykerConstance M Ryker
DETAILED DESCRIPTION OF WORK.
Install 500 gallon undergound LP 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 _ Generato
_ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First FI
or:
Cost of Construction: $ 4,295.00 Utilities: —Sewer
Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameJoseph F RykerConstance M Ryker Name: Michael
71axman
Address: 5211 EAGLE DR Company: Energized
Electric
City: Fort Pierce State: — Address:4252 Bandy
Blvd
Zip Code: 34951 Fax: City: Ft. Pierce
State: FI
Phone No. 772-466-3312 Zip Code: 3498
Fax: 772-318-6672
E-Mail: Phone N0772-
66-1095
Fill in fee simple Title Holder on next page ( if different E-Mail energize(Igenerators@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.
ENTAL CONSTRUCTION LIEN LAW INFORMATIO
:
ENGINEER: Not Applicable
F
MORTGAGE
Address:
City:
Zip:
OMPANY: Not ApplicableName:
City: State:
Zip: Phone
State:
Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
BONDING COMPANY:
Name:
Address:
City:
Zip:
_Not Applicable
Address:
City:
Zip: Phone:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit
I certify that no work or installation has commenced prior to the issuance of a perrr
to do the work and installation as indicated.
it.
St. Lucie County makes no representation that is granting a permit will authorize th
which is in conflict with any applicable Home Owners Association rules, bylaws or a
structure. Please consult with your Home Owners Association and review your dee
In consideration of the granting of this requested permit, I do hereby agree that I w
in accordance with the approved plans, the Florida Building Codes and St. Lucie County
permit holder to build the subject structure
id covenants that may restrict or prohibit such
for any restrictions which may apply.
II, in all respects, perform the work
Amendments.
The following building permit applications are exempt from undergoing a full concu
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory
WARNING TO OWNER: Your failure to Record a Notice of Commenceme
improvements to your property. A Notice of Commencement mu
Lucie County and posted on t jobsite before the first inspection.
with lender or an attorneyore commencingwork or recordin
rency review: room additions,
uses to another non-residential use
t may result in paying twice for
t be recorded in the public records of St.
If you intend to obt I financing, consult
our Noti of o` encement.
Signature of Owner ssee/ ontractor as Agent for Owner
Signature of C
tractor/Li ense Holder
STATE OF FLO l /
OF 1 ?
STATE OF FLOCOUNTY
COUNTY OF —To,
and subscribed before me of
or Online Notarization
I , 2020 by
Sworn to (or affirmed) and subscribed before me of
hysical Pre ence or Online Notarization
this day of 2020 by
Swo n to (or affirmed)
NPhysical Presence
this day of
�JrV A V) ( V-)
[ICAs r
r
Name of person making statement.
Name of person
making statement.
Personally Known OR Produced Identification
Type of Identification
Produced IA
Personally Know
Type of Identificz
Produced
' OR Produced Identification
tion
(Signatu r
;..., ; Y u CE
MY COMMISSION#
Commis yc :<:
'.;OF FL0.• Bonded TIN'U
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Pubk Underwriters
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEG
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
TATId,N SEA TURTLE MANGROVE
REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Rev. 5
Ali
*Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pie
*Palm Beach 561-752-0214, 1550 Latham Rd, Suite 3,
FLa 4981, Fax 72-318-6672*
st P m Beach, L, 33409*
Proposal / Agreem�n '
Joseph Ryker November 19, 2020
5211 Eagle Drive
Fort Pierce, Florida 34951
772-466-6612
1) Supply and install (1) customer owned 500 gallc n 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 prop ne, price per gallon will be
based off Thompson Gas' market prices
for the sum$4,295.00
TERMS:
Charges &•Payments: Charges are due -in full at time servicesare-rendered
charge and customer agrees to pay a late fee for all past due payments, such
applicable law. Customer shall be responsible and agrees to pay for all charge
other charges/fees.
Proposal/Contract pricing good for 30 days from I
$495.00 is due @ Sigr
$3 800.00 is due @ Gas Co
We appreciate the opportunity you have extended us
like to thank you in advance for your consideration.
Authorized signature:
John Mauri
� (printed
complete the work n accordance t the above specifications a
terms outlined above.
Signature
This agreement shall be construed under the laws of the State of Florida. This agreen
parties and supersedes all previous verbal or written agreements: there are no other
set forth herein. If any conflicts exist in this agreement between terms which are prin
typed or written language shall govern.
mless otherwise - stated -below. Contractor may
yes not to exceed the maximum allowed rate by
billed, applicable taxes, applicable legal fees and
roposal/Contract date
ing
npletion
quote on this work and would
ame), authorize Energized Gas to
I conditions. I agree to pay as per
Date
ent contains the entire understanding of the
+greements, representations or warranties not
ed and those which are typed or written, the
Paae 2 of 3
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 i stallation*. 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 cutlets, 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 p
Customer is responsible for obtaining HOA/POA approval. Installer
to obtain final approval.
If home is located in flood zone, the additional cost will be the i
down, or buoyancy pad is required per the building department
A site survey of your property showing all property lines is required
along with this signed proposal.
*To include sod replacement a charge of
CUSTOMER -SIGNATURE FOR ACKNOWLEDGMI
09/
PRINTED NAME
-
SIGNATU E
is initiated.
not responsible for customers failing
bility of the homeowner if a tank tie
pull a permit and can be submitted
95 applies.
OF ABOVE TERMS
f
DATE
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