HomeMy WebLinkAboutMcCorkle gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
�1, VC, BC"EI E
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
PROPOSED IMPROVEMENT LOCATION:
Address: 905 S Header Canal RD Fort Pierce, FL 34945
Property Tax ID #. 2214-501-0005-000-6
Site Plan Name:
Project Name: McCorkle gas
DETAILED DESCRIPTION OF WORK:
install gas line to generator and final connect
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 5
Block No.
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; _
Cost of Construction: $ 1295.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Kendra McCorkle
Name: Michael Flaxman
Address:905 5 Header Canal RD
Company: Energized Electric
City: Ft Pierce State:
Zip Code: 34945 Fax:
Phone No.7722162091
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-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.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Zip:
Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 tl e j site before the first inspection. If you intend to obt3'yi financing, consult
with lender or an attoflxev beKiWcommencine work or recordine vour Notice of Cor6w(encement.
Signature of Owner/ essee/ ontractor as Agent for Owner
Signature of Contr for/Lic nse Holder
STATE OF FLORD
STATE OF FLO9A
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COUNTY OF _'i�.r
COUNTYOF t
5 or to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Phsicalal Pre ence or Online NotarizationPlvsical
Preece or_ Online Notarization
this � day of , 202d by
this a day of , 2020 by
I f r �nr� 4�1(�
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Name of person making statement.
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Name of person making statement.
Personally Known ",IV OR Produced Identification
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ney.5/b/2u
I '
DER
*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*
Proposal / Agreement
Kendra McCorkie
905 South Header Canal Road
Fort Pierce, FL 34945
772-216-2091
jrmccorkle77Ccbgmail.com
kendra.mccorkle@syngenta.com
April 14, 2021
1) Run lines to generator from customer owned existing (1) 500 gallon
underground LP Tank and final connect.
2) Price includes backfilling and removing dirt.
3) Obtain all permits & inspections needed.
for the sum o r $1,295,00
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
$ 250.00 due @ Gas Tank Installation
$ 250.00 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:
Brian Orr 772-353-8734
Acceptance of Proposal
I, Kendra McCorkle
complete the work in accordance with the
terms outlined above.
Signature
(printed name), authorize Energized Gas to
above specifications and conditions. I agree to pay as per
Date 4/27/2021
This agreement shall be construed under the laws of the State of Florida. This agreement contains the entire understanding of the
parties and supersedes ail 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
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
Kendra McCorkle
PRINTED NAME
SIGNATURE
4/27/2021
DATE
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