HomeMy WebLinkAboutSchmeid app, contractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
oILLCc;1
Building Permit Application
Planning and Development Services Commercial Residential
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG FLinding
PERMIT APPLICATION FOR: E�-CC=f t_
PROPOSED IMPROVEMENT LOCATION
Address: L.L ''
� .� � � . � Lot No. 1 �
Property Tax ID #: �(� ' Block No. J
Site Plan Name:
Project Name: ( t
DETAILED DESCRIPTION OF WORK:
l
New Electrical Meter. Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
it's
Additional work to be performed under this permit— check all that apply Windows/Doors Pond
Gas Tank —Gas Piping _ Shutters
Mechanical — Pitch
— Sprinklers Generator Roof
Electric � Plumbing — P —
5q. Ft. of First Floor:
Total Sq. Ft of Construction: uu
Utilities: Sewer —Septic Building Height:
Cost of Construction: $ —
OWNER/LESSEE:
Name 11
Address:
Stater
City: 1�{_
Zip Coder Fax:
Phone No.
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: 1
Company:
Address:
: State:
City
E- Zip Code: ` Fax:
Phone Nab
E-Mail `&EP4— �
State or County License
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
ED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORD
Name: _
Address:
City: _
Zip:
EER: _ Not Ap
11
State
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
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 County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wNth your Homeowners 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 jobs' before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before 2 mmencing work or recording vour Notice of Commencement.
Signature of Owner/ Le e Contra or as Agent for Owner
STATE OF FLORIDA
COUNTY OF a C j
-A
Sworn to (or affir ed`) and subscribed before me of
Physical Presence
or _ Online Notarization
this ` day of { 1C 5 20DI by
n
Name of person making statement.
DANIELLE GONCALVES
'
MY CbMMISSION # GG 232946
Personally Known OR Produced Identification
`.`.
EXPIRES: June 27, 2022
T of Identification Produce
1. z°
�
Bonded Thru Not&ry Pub�o Undererller¢
LEI
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/21
*Treasure Coast 772.466-1095, 4252 Sandy 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
Alan Schmied
519 paurotis Ln
Fort Pierce FL 34982
401-996-9348
AlanSchm'ei d(c),gmail com
July 14, 2021
i) Supply Labor & material for the following Scope of Electric work,
2) Supply & Install mechanical Interlock with existing 50-amp genetor breaker
3) Remove existing genertor circuit that passes through meter,
4) Install new 50 -amp rated generator circuit from existing Reliance PBSO generator inlet to 50-
amp generator. Backfeed breaker,
5) Supply & Install now panel schedule, copy from existing scheduler
6) Test and train customer on customer supplied portable generator system.
7) Obtain all permits, drawings and inspections.
or the sum of.. $ o.00
0
Charges e. Paymentai 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: paxments, such fees not to exceed the maximum allowed rate by
applicable low. Customer shall be responsible and agrees to pay or all charges billed, eppifcabie taxes, applicable legal fees and
other charges/fees. Customer shall be responsible for any stop payment, charge backs or returnee checks in the amount of
$25.90 or 3% whichever is greater.
Proposal/Contract pricing good for 30 days. from Proposal/Contract date
_ $750.00 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:
Mike Fiaxman
Acceotanceof Proposal
/'�
complete the work In accordan
terms outlinedjabgvlr.,
Signature
ad name), authorize Energized Gas to
and conditions. I agree to pay as per
Date ;Z., I
$395.00 of the initial deposit is NON REFUNDABLE if customer cancels after signing this contract
or makes a deposit for any reason. No refunds will be given at all after permits have been
applied for or Installation begins
This agreement shall be construed under the laws of the State of Florida. This agreement contains the entireunderstanding 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
Charges e. Paymentai 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: paxments, such fees not to exceed the maximum allowed rate by
applicable low. Customer shall be responsible and agrees to pay or all charges billed, eppifcabie taxes, applicable legal fees and
other charges/fees. Customer shall be responsible for any stop payment, charge backs or returnee checks in the amount of
$25.90 or 3% whichever is greater.
Proposal/Contract pricing good for 30 days. from Proposal/Contract date
_ $750.00 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:
Mike Fiaxman
Acceotanceof Proposal
/'�
complete the work In accordan
terms outlinedjabgvlr.,
Signature
ad name), authorize Energized Gas to
and conditions. I agree to pay as per
Date ;Z., I
$395.00 of the initial deposit is NON REFUNDABLE if customer cancels after signing this contract
or makes a deposit for any reason. No refunds will be given at all after permits have been
applied for or Installation begins
This agreement shall be construed under the laws of the State of Florida. This agreement contains the entireunderstanding 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