HomeMy WebLinkAboutSantacroce gas app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
To Ll Lit, c v r� j
LL
U L"�
Planning and Development Services
Building and Code Regulation Division
Permit Number:
Building Permit Applicationion
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR :G/kS TANK
PROPOSED IMPROVEMENT LO(�ATION:
Address: 9331 Avenel LN Port St Lucie, 1:134986
Property Tax I D #: �322-502-0020-000-�
Site Plan Name:
Project Name: Santacroce gas
DETAILED DESCRIPTION OF WORK:
Install 250 gallon underground gas tank vvith fine to generator
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be pe formed
_Mechanical Gas Tank
Electric
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: S 3295-00
OWNER/LESSEE:
under this permit — check all that apply:
Residential X
Lot No. 14
Block No.
_Gas Piping _Shutters Windows/Doors Pond
Sprinklers � Generator Roof Pitch
Sq. Ft, of First Floor:
Utilities; � Sewer i Septic Building Height:
NarneJohn R Santacroce
Address:9331 Avenel LN
City: Post ST Lucie State:
Zip Code: 34986-IMIMM --- MOUN ------- Fax:
Phone No. 7722015194
E-Mai I: KSantacroce@comcast.net
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
CONTRACTOR:
Name: Michael Flaxman
Company: Energized Electric
Address*-4252 Bandy Blvd
City: Ft pierce State: FIL
Zip Code: 34981 Fax:
Phone No7724661095
E-Mail energizedgenerators@gmail.com
State or County License LQ31756
It value of construction is 2500 or more, a RECOORDED 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 M0RTr-.iir-.F rnnnunniv
Name:
Address. --
city*
state.
Zip: Phone
FEE SIMPLE TITLE HOLDER0
:
N Applicable
Name:
Address:
City:
Z do
I ` Phone:
Not Applicable
Name:
Address:
City: State:
Zip: Phone -
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Applicationis hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has com;-nenced 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 Homey Owners Association rules, bylaws or and covenants that may restrict structure. Please consult withyour Home Ov�rners Association and reviewyour deed for an restrictions which ma oa prly.
hibit such
y Y pp
Inconsideration o� the granting of this requested permit, I do hereby agree that 1 will, in al! 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, wails, 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 g
jc�bsite before the first inspection. If you iniend to obtain f'nancing, consult
with lender or an atto ne be commencingwork or recordin our Notice of Cornrcement.
F— 'If Z Z I
Signature of Owner/
STATE OF FLORI
COUNTY OF
ssee/Coxtractor as Agent for Owner
S � to (or affirmed) and subscribed before me of
sisal Presjn�Online Notarization
r
phis � day of 702 by
jvame of person making statement.
Personally Known
Type of Identification
PtMC c e d
F
DR Produced Identification
(Signature of Notary Public'-"'tate of Flori4 da J
Commission No. (SE;al)
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev�76720
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
/ •i7/ f
Signature of Co tr,-actor/License Holder
STATE OF FLO
COUNTY OF
Sx n to (or affirmed) and subscribed before me of
ical Pr e c or Online Notarization
this hysof 202by
Name of person making statement.
Personally Known
Type of identification
4R Produced Identification
kz5ignature of Notary Public- State of Florida }
Commission No.
PLANS
REVIEW
VEGETATION
REVIEW
(Seal)
SEA TURTLE
REVIEW
MANGROVE
REVIEW
*Treasure Coast 772,466
Vy
-1095, 4252 Bandy Blvd, Fart Pierce,, FL, 34981, Fax 77?_1 18-6672=�
�Yaim Beach 561-752-0214-1,27,58 Old Okeechobee Blvd', S-u"te ), West Palm Beach. FL. 33409*
Jack Santacroce
9331 Avenel Lane
Port St Lucie, FL 34986
772-201-5194
ksantacroce-.@comcast, net
Proposal / Agreement
May 7, 2021
1) Supply and install (1) customer owned 250 gallon underground LP Tank with
gas line to generator and final connect.
2) Obtain all permits & inspections needed.
3) Price includes backfilling and removing dirt.
4) Price does NOT include filling the tank with propane, price per gallon will be
based off Thompson Glas" market prices.
or the sum o f $32295 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 i-ate 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. Customer shall be responsible for any stop payment, charge backs or returned chicks in the amount of
$25.00 or 3% whichever is greater.
Proposal/Coni:ract pricing good for 30 days from Proposal/Contract date
$1,r995.00 due @ Signing
$ S00,00 due @ Gas Tank Installation
$ 51130,00 due @ Gas Ling 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:
Acceptance of Proposal
, F
.. �:
complete the work in accordanCE! with the above
teams outlined above,
iti Hato re
(printed name), authorize Energized Gas to
specifications and conditions. I agree to pay as per
Date ��` /
This rmnt shall be construedunder the laws of the
State of Florida. This agreement contains the entire
understanding f the
parties and supersedes III previous verbal or writtenagreements:,
there r r� other agreements, representations r
t firth herein. If ar�r conflicts pit in this r � warranties not
meat between n terms which h 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 sprinkl+�r lines and/or damaged/broken wader or sewer
lines.
This contract price does NOT includ(.:., 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 HO /R4A approval. Installer is not responsible for customers failingto obtain final approval,
If home is located in flood zone, the additional cosh 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
along with this signed proposal,
all property lines is required to pull a permit and can be submitted
$395.00 of the initial deposit is INON REFUNDABLE if customer cancels after signing this contract
or makes a deposit for any re=asan. No refunds will be given at all after permits have been
applied for or installation begins.
177
CUSTOMER SIGNATURE FOR ACKNOWLEDGMENT OF ABOVE TERMS
Ilk
PRINTED NAME
IGNAT
19
DATE
Page 3 of 3