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Home My WebLink AboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ILMME "Coll 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 PR A Address: 185 Sandia Ave Port St Lucie, FL 34983 Property Tax lD#: 3419-540-0074-000-3 Lot No.20 Site Plan Name: Block No. 45 Project Name: Burkhead gas N 'K ff, FE F—J install gas line to generator and final connect New Electrical Meter Second Electrical Meter NP, 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: ied L T U� W-11& Name Daniel Burkhead Name:Michael Flaxman Address.185 Sandia Ave Company:Energized Electric St' City: Port St Lucie State: Address:4252 Bandy Blvd Zip Code: 34983 Fax: City: Ft Pierce State:FL Phone No.7723423931 Zip Code: 34981 Fax: E-Mail: Phone N07724661095 Fill in fee simple Title Holder on next page(if different E-Mail energizedgenerators@gmail.com from the Owner listed above) 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$7,500 or more,a RECORDED Notice of Commencement is required. ,i � D SU[' LAME(uTPLt�iO'�1STRUCTIN'LIEN'LAUVINFORMATION, �n�� < ° _'°" ,� �*."b"�i+;$a , 9t.,i- a�aetll '.� •s'. 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: _Not Applicable Name: 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 Count 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 Jq4ite before the first inspection. If you intend to obt ' financing, consult with lender or an at rn bef ommencin work or recordingour N ti of Co ncement. Signature of Owner/L see/C tractor as Agent for Owner Signature of Contra or/Lic se Holder STATE OF FLOR112A STATE OF FLOR!4 ZJ l�U- ,�� COUNTY OF A COUNTY OF S or -to(or affirmed)and subscribed before me of S rn to(or affirmed)and subscribed before me of yysical Presence or Online Notarization Physical Pre ence or_Online Notarization this (9 day of 2020 by this day of , 202t by Mir Am;-1 f (TC 0 'A(c r�v�Q_Jtcax�n 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 I 7uceJd Pro01ed� , 0Q ' sr� _ — (Signatu g;; Sd -1. 6 LV S (Signature Commis " i,* WCOMMISSION#Ga� s ?�t W00MMISSION#f3 cr 272a] Commissio _g. ;June27, " 9jr 02 SoodedThru Notary publloUMonv(A 33'j p� •' Sond9 ThruNotaryPubNcUndorvrcllore nw„ REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20 ti -- - *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* Proposal / Agreement Daniel Burkhead June 23, 2020 185 Se Sandia Dr Port Saint Lucie, FL 34983 772-342-3931 DanBurkhead4@gmail.com 1) Supply and install aboveground gas line to generator and final connect 2) Price includes all labor, material and permits NOTE: Gas line to be installed by Thompson Gas For the sum of.- $995•00 1786 SW Biltmore St, Port ST Lucie, FL, 34984 *Licensed & Insured FL34747 Toll Free 855-PROGAS4 *Treasure Coast 772-777-8133 *Palm Beach 561-752-0214 *Fax 772-318-6673 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 $497.50 is due @ Gas Line Installation $497.50 is due @ Completion 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: �cshV\ Aw'VO Acceptance of Proposal H�—J� D (printed name), authorize Energized Gas to complete the wor in accordance he above specifications and conditions. I agree to pay as per ter tlined o e. Date 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. Page 2 of 2 CONTRACT TERMS AND CONDITIONS Installation will comply with all local and state regulations and be consistent with standard industry code. Installer is 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 Z �A � 7D:7i) SIGNATURE DATE Page 2 of 2