HomeMy WebLinkAboutCox gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
u
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR:GAS
PROPOSED IMPROVEMENT LOCATION:
7'] rll ICrni rr-irr�rr��„
r-xuure5s: ,-- , 1, 1, rL r-ierce, rL, M4 W)
Property Tax ID #: '1414-/U1-0035-000-0
Site Plan Name:
Project Name: Cox gen
Residential X
Lot No. H
Block No. 4
DE
TAILED
DESCRIPTION OF WORK: g 1
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 _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 995.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTammie Cox
Name: Michael Flaxman
Address:5500 Saint Lucie BLVD Lot D5
Company: Energized Electric
City: Ft pierce
State
Zip Code: 34946 Fax:
Phone No.6367343949
Address:4252 bandy Blvd
City: Ft Pierce State: FL
Zip Code: 34981 Fax:
Phone No7724661095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of constructinn is 7snn n,- .,,, _
E-Mail energizedgenerators@gmail.com
State or County LicenseLQ31756
cnCll 1D It Iq U If UU.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
LEMERUCPPNTAL CONSTTION LIEN LAW INFORMATION:
SIGNER/ENGINEER: Not Applicable
me:
F
MORTGAGE COMPANY: NotApplicable
dress:
Name:
City: State:
Address:
City:
Zip: Phone
State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRArrnR AGGinviT.
C�—y inaue to ooiain 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 jobsite before the first inspection. If you intend o obtain financing, consult
with lender or an attorney bef� commencing work or recording yourpotic Commencement.
Signature of Owner�L see/Co tractor as Agent for Owner
STATE OF FLORID
COUNTY OF �� \r .
Sworn to (or affirmed) and subscribed before me of
�sical Pres ce or Online Notarization
this � day of 202A by
Name cf person making state ent.
Personally Known FOR produced Identification
Type of Identification
Proe ui—O�d A
(Signatu ry Puf9 fiigN1Skhk 0 ✓i H� )
MAY CO vIViSSiON # GG 232946
Commis Ft14 EXPIRES:Juna 27, 2�
Signature of 96ntraq%r/License Holder
STATE OF FLORI
COUNTY
Svfm to (or affirmed) and subscribed before me of
hysical Pres nce or Online Notarization
this day of 202k by
, ,-A 0 art ir)
Name of person ma ing statement.
Personally Known OR Produced Identifica
tion
Type of Identification
Pro uced
+' D. IELLE GO ( VES
i5 ! G .3'
(Signat s t.f y Pu0ZFSf-6t�dr@ - Ib a.
6ondM Thru Notary Pub11c UndentrnIrs
Commis (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
*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*
Tammie Cox
123 Queen Frederika Court
Fort Pierce, Florida 34949
636-734-3949
tammiercoK@qmail.com
Proposal / Agreement
March 18, 2021
1) Energized Electric to supply & install aboveground gas line from Natural Gas
Meter to generator and final connect.
2) Obtain all permits & inspections needed.
or the sum of: $995. o0
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 @ Signing
$ 300.00 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 Maruri 727-626-4691
* tAcceptance of Proposal
I, Tammie R Cox
complete the work in accordance with the above specifications and conditions. I rinted name), authorize
to Energized a asperterms outlined above.
9 pay p
Signature Date 04/09/2021
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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