HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COCJNTY`
F LORI 77�-�
_
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 x
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: LP Gas -Residential
PROPOSED IMPROVEMENT LOCATION:
Address: 3604 Grove Ct, Fort Pierce, FL 34951
Property Tax ID #: 1327-805-0009-000-1 Lot No.13
Site Plan Name: COMPLETE/HARPER Block No,
Project Name: COMPLETE/HARPER
DETAILED DESCRIPTION OF WORK:
INSTALL 500 GAL LIG LP TANK AND LINE TO GENERATOR AND RANGE
CONSTRUCTION INFORMATION:
Additional work to be performed under this Zcas
It — check all that apply:
Mechanical XGasTank Piping _ Shutters
_ Electric — Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 4314.35
Sq. Ft. of First Floor:
Utilities: _Sewer ,Septic
_ Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William Harper, Jr
Name: Tom Fite
Company: Ferrellga5
Address.3604 Grove Ct�
city: Fort Pierce _
State: FL
Address: 3232 SE Dixie Hwy
Zip Code: 34951 Fax:
City: Stuart state: FL
Phone No. 781-228-9875
zip Code: 34997 Fax: 772-287-3456
E-Mail: charp0801 @outlook. corn
Phone No 772-287-4330
Fill in fee simple Title Holder on next page (if different
E-mail KimWilkins@ferrellgas.com
from the Owner listed above)
State or County License 31370
IT vawe oT construction Is yz5UU or more, a RLCOROED Notice of Commencement is required.
if value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement is required.
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:
BONDING COMPANY: Not Applicable
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 restrtct 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 al I 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE B FORE THE FIRST INSPECTION. IF YOU INTENT] TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COKMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 26 day of March 2o21 by
this 2B day of March 2o21 by
Tom Fite
Tam Fite
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
Pro u d
Perdu d
L�` 2 ��
.;'LJJ
ov-
(Signature of Nota blic State of Floridas st�� r���' Z�'S�gn�tore
of Notary P lic Stat
Commission No. FF063105� (,se \��' a �e. �'
commission No. FF063105 (5e � f
REVIEWS
FRONT
ZONIN.
SUPERVISOR
PLANS
VEGETATION >
SEA TURTLE
MANGROVE
COUNTER
Rpm V
REVIEW
REVIEW
REVIEW
'REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
orerreligos
ID
William Harper
3604 Grove Court
FT Pierce FL 34951
charpOYg 1gngtInok, cnm
Phone 781 228 9875
To Install:
Doug Kelp
Account Manager
772 216-2656 cell 772 287-3456 fax
rlaugl;Pr� �fPrrPlin.�.rnrn_
Date: 23Feb-21
Purchase Gas Line Only
Ext. Line up to 25' of gas piping
$
350.00 •Minimumaf 3M.00 additional per foot @ $ 12.50
Int Line up to 70' of gas piping
$
1.015.00-irmimrmrorsssoA0additional per foot @ $ 14,50
Final Connect and 1 outlet
$
125.00 safetychecharmistart Up
Regulators
$
90.00 Regulators, Shut-off Valves, Risers, etc.
Sub Total
$
1580.00
Tax
7.00% $
110.60
Permit
To be part ofgweratorii mtWiWa
TOTAL
$
1,690.60
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• Revisions made after permittng will require an additional 3-6 weeks for processing & there will be addilional charges.
• Fenellgas is not responsible for damage to u9 Pipes or lines {including irrigation, electric, etc.) not marked by central locating service. Homeowner is responsible to
mark their own sprinkler or low voltage lines
• Famellgas is nut responsibiefor placement orphysical adjustment ofapplrances.
• Ferrellgas is not responsible for damage to or replacement of landscaping, concrete sidewalks orany electrical.
• Cusiomer is responsible for pmviding labor and conversion kit to canvert any gas appliance for use of propane
• Generators are required to have afk>oble lire to connect to gas.
• Customers credit must be approved prior tocommencerrrent of any work.
• Any sleeving, directional boring, excessive roots, orcaral rock wR require art addition charge.
• Bonding of gas lines to be done by uthers.
• Underground tanks includes cathodic protection.
• A 60°% deposit fs due upon aoceptanc e. A 10%cancellation penalty YAN apply.
Please sign If you have read &agree tofhe foregoing proposed contract & accept t
'The undersigned agrees that in the event that itbecwKz necessary Co litigate any of tre terms & a)Wifiorra of Ws conduct. that the undersigned Shad be responsible to FerreNgas LP
for any & all attorney toss andlor costs w=e d by Fegfiggas LP relating to the forcerroentof ilus contract.'
Customer Signature; Date:
Ferrellgas Signature; DftDate: 03/03/2021
Valid for 30 Days
Contact Information
Penny Randall 561 746 4534 Ext 25104
Kiln Wilkins 772 287 4330 Ext 22578
Jane Conner 772 287 4330 Ext 25101