HomeMy WebLinkAboutRalston gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
ST. LuCiE
C.Ot1NT�Y
F L O R I U A
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercia
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: 6u� 11
,
PROPOSED IMPROVEMENT LOCATION:
Address: 8288 Sandpine Cir Port St Lucie, FL 34952
Property Tax ID #: 3426-703-0049-000-0
Site Plan Name:
Project Name: Ralston gas
DETAILED DESCRIPTION OF WORK:
install underground 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 K-G as Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 995.00
Generator
Sq. Ft. of First Floor:
Residential X
Lot No.35
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Paul Ralston
Address: 8288 Sandpine Cir
Name: Michael Flaxman
Company: Energized Electric
Address:4252 Bandy Blvd
City: Port ST Lucie State: _
Zip Code: 34952 Fax:
Phone No.7726317187
City: Ft Pierce State: FL
Zip Code: 34981 Fax: 7723186672
Phone N07724661095
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail energizedgenerators@gmail.com
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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-residential 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 posted on the jo�site before the first inspection. If you intend to ob in financing, consult
with lender or an attorney befor commencing work or recording vour Notice of mencement.
Signature of Owner/ ess e/ on actor as Agent for Owner
Signature of on ctor/License Holder
STATE OF FLORIDA
STATE OF FLO A
COUNTY OF ,a �"1 A ) C
COUNTY OF ) a -A
Sworn to (or affirmed) and subscribed before me of
Swan to (or affirmed) and subscribed before me of
�ysical Presence or Online Notarization
if Physical Presence or Online Notarization
this day ofR2021 by
this day of202d by
Lh
rl'c.�0 a6!�2
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known I'OR Produced Identification
Type of Identification
Type of Identification
Pr ucecl
'�Jk I I I �- , A"A/
Pro ce—
I 7AW—C,
(Signat
i - to of Florida)
( S „� )
Commi
. DANIELLEGONCALVE�Q
ri #GG237g�1)
;'��`•"'"'��`;; DANIELLEGONCALVES
Co ;*1i n #dolly COMMISSION # GG 232946 ea I )
'o`.' EXPIRES
;FQ; : June 27, 2022
Ps EX
''fi P` PIRES: June 27, 2022
g�
wtg F3ond ed Thru No
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 516/20
E7
�X -, CC- 6 rt 1'
1 �'�
*Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pierce, FL, 34981, Fax 772-318-6672*
*Palm Beach 561-752-0214, 1700 Latham Rd, Suite 2, West Palm Beach, FL, 33409*
Proposal / Agreement
Paul Ralston
8288 SandPine Circle
Port St Lucie, Florida 34952
(772) 631-7187
maint56@yahoo.com
February 11, 2021
1) Energized Electric .to supply.& install underground gas line from Natural Gas
Meter to generator and final connect.
2) Obtain all permits & inspections needed.
R
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 due @ Singing
$ 700.00 due @ Gas Line Installation
$ 200.00 due @ Final Inspection
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:
John,Karuri
Acceptance of Proposal
I� (printed name), authorize Energized Gas to
complete the work in accordance with the above specifications and conditions. I agree to pay as per
terms ouLlined above.
Date 2-
Signature
.Z2-Z02l
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.
Page 2 of 3
f
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
- �CA r v-
PRINTED NAME
01,,
SIGNATURE
DATE
Page 3 of 3