HomeMy WebLinkAboutLevy gen app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
D ' 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
Address: 10320 INVERNESS WAY Port St Lucie, FL 34986
Property Tax ID #: 3321-802-0028-000-9
Site Plan Name:
Project Name: Levy gen
Install 500 gallon underground gas tank with line to
New Electrical Meter Second Electrical
Additional work to be performed under this permit —check all that apply:
_Mechanical S GasTank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 4450.00
Sq. Ft. of First Floor:
Lot No.22
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
u
t,
A
ao
Name Harold Levy
Name:Michael Flaxmanv
Address:10320 INVERNESS WAY
Company: Energized Electric
City: Port ST Lucie State: _
Zip Code: 34986 Fax:
Phone No.9086101750
Address:4252 Bandy Blvd
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone N07724661095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailenergizedgenerators@gmail.com
State or County License LQ31756 / L145030
it value or conscruaion is zbuu or more, a RtcoRDED 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 COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
V VVIVLK/ LUIN I KAL 1 UK AFFil)V1 I : 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 wid 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 ail 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 jobsite before the first inspection. if you intend to obtain financing, consult
with lender or an attorney befvlie commencing work or recording your Notice Commencement.
Signature of Owner/ Le.O96/Contractor as Agent far Owner ' Signature of Gontra or/License Holder
STATE OF FLORi A STATE OF FLORI
COUNTY OF COUNTY OF
S-n to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
wI Physical Pres ce or Online Notarization Y. Ph sisal Pres pr Online Notarization
this day of 202C by this day of h l 202Q by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced A
t5!gnaiure or !votary, I ubl!c # '1}1f51tri "k "
;_ lulY COMMISSION # GC 232946
Commission` l0. r` FXPIRGS:Jun
F?onded Thru Not_.
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6120 -
Personally Known OR Produced Identification
Type of identification
Pr ed
(Signature of Notary Public- State of Florida )
Comm
MV COMMISSION # GG 232946
L `•"F`;;, LiapdedThrul4 to Pub!ie
SUPERVISOR PLAN _ l.)ndenvrsters �-- MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
Effliew
*Treasure Coast 772-466-1095, 4252 Bandy Blvd, Fort Pierce, FL, 34981, Fax 772-318-6672*
*Palm Beach 561-752-0214, 2758 Old Okeechobee Blvd, Suite 9, West Palm Beach, FL, 33409*
Harold Levy
10320 Inverness Way
Port St. Lucie, Florida 34986
908-610-1750
abl490aol.com
atrusgenius@aoi.com
Proposal / Agreement
March 30, 2021
1) Supply and install (1) customer owned 500 gallon underground LP Tank with
gas line to generator and final connect.
2) Price includes 15ft extended service.
3) Price includes backfilling and removing dirt.
4) Obtain all permits & inspections needed.
5) Price does NOT include filling the tank with propane, price per gallon will be
based off Thompson Gas' market prices.
For the sun o : $4.9450•0
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 iaw. 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 @ Signing
$1,827.50 due @ Gas Tank Installation
$1,827.50 due @ Gas Line Connection
300.00 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 Maruri 772-626-4691
Acceptance of Proposal
if IMRvLa _///• `AO�y/ (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 3
Signature
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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