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DECO 151010
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GALE INSULATION st.
S/O#406339811
CERTIFICATE OF INSULATION — INSTALLATION BUILDING PERMIT# — 0(tCj(f
JOB ADDRESS: 2990 JOHNSTON RD, FORT PIERCE, FLORIDA
STATEMENT OF COMPLIANCE: We, the undersigned, hereby certify that the thermal insulation has been installed in the
referenced building in compliance with the Florida Building Code- Energy Conservation and the approved plans and
specifications, and in accordance with good construction practice. The insulation furnished is of the type, thickness and R-
value as set forth below
------ ---- ---- ---
AREA TYPE THICKNESS R-VALUE
_ MANUFACTURER
ROOF AREA SPRAY FOAM 5.5 R-22 BASF ENERTITE G
I GARAGE ROOF
AREA ---�- --..— -_—._�
INSULATION CGC1512179 ERTIFICATION DATE: SEPTEMBER 4, 2020.
INSULATION CONTRACTOR'S SIGNATURE
BUILDER: PEACO BUILDERS: SIGNATURE:
1 PERSONALLY KNOW THE AFFIANT, JEROME SCHIMMELPFENNING.
Sworn to and subscribed before me this of , 2020.
Notary Public, State of Florida
a9 , Notary oubbc State or Honda
Yennitza Frtrnandez
M;Commisszon GG 22UD40
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Planning and Development Services
Building and Codeode Regulations
ations
2300 Virginia Avenue
Fort Pierce,FL 34983 RECEIVED
• s - ' 772-462-1553 DEC 151010
Fax 772-462-W3
Permitting Depaamen,
St, Lucie County
TEMPORARY EARLY POWER RELEASE
�uw�i ynJ '►-:,q4,J 1U—
(Name of Tenant or Owner)
The Tenant or Owner requests St Lucie County Development Services Department to release the
electrical power at Z,G90 c1Ohn)S4:%2& 20 (address, including suite number,
as posted on the electric meter and the building) for building permit #ZOOZ-0499, for the
purpose of construction and testing building systems, including air conditioning, refrigeration,
lighting,power and control circuits with the following stipulations:
1. Incomplete or untested circuits are NOT to be energized without properly licensed electrical
personnel on the jobsite and no systems are to remain energized beyond the testing/temporary
purpose without proper inspection by the St Lucie County Building Department appropriately
licensed person(s).
2.All panels and disconnects riot in use must be locked in the"OFF"position or fuses removed.
3.Proper procedures for Iockout/tagout must be in place.
4.The electrical equipment mom(where applicable)will remain locked at all times with the key in
the possession of the electrical contractor.
5. All final inspections relative to the closeout of this project must be requested and passed in a
timely manner as determined by the Electrical Inspector and/or the Building Official.
6. The building may not be occupied before a Certificate of Occupancy(C.O.)is issued.
7.No stocking of materials,other than those required for construction is permitted by this agreement
8.No on-site occupancy or training of personnel employed by the occupant,business entity or owner
is permitted by this agreement
9.No furniture,racks,furnishings or other personal or corporate property is permitted on site by this
agreement.
10. Construction power remains covered by the requirements for GFCI protection and all other
requirements of the governing Codes,see National Electrical Code(NEC)Article 590.
Violation of this agreement may result in the immediate termination of the electrical power without
prior notice or warning to the affected parties. This form requires all of the following signatures
prior to power being released.The undersigned acknowledge that the operation of air conditioning
equipment while constriction is in progress may create or increase the risk of contamination or
premature failure of the equipment.
The undersigned acknowledges the above listed stipulations,agrees to the terms of this agreement
and agrees to hold St Lucie County harmless from any damages that may arise as a result of the
release of power to the premises. The undersigned hereby requests power to be released for this
project.This fort does not guarantee power,which is at the discretion and control of the electrical
utility.
1
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RECEIVED
L' '1- vV 7--•=- DEC 151010
Permitting Department
St. Lucie County
Important: The occupant of the property (or other appropriate party) shall have made proper
application to the electric utility, paid any applicable fees or deposits, and requested power in a
timely and informed manner. St Lucie County is not responsible for any delays in the receipt of
electric power.
We acknowledge and accept the terms of this permission. We further acknowledge that violation
of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy
of the site may result in immediate disconnection of this temporary power without warning and
Y P �' P 8
hereby release St Lucie County and all representatives of any and all liability resulting from us not
abiding with this agreement.
Goldstar Electric
Print Name-Electrical Contractor Company Name
12/14/2020 zo co
Signa_uue-E(ctrical Contractor Date Signatu - Date
John Cavnar us JL f-('�^� 104 ,,, ;C-(
Print Name-Electrical Contractor Print Name-Owner
7c 72> 380 _5913 ( j�_ �
Phone Number-Electrical Contractor Phone Number-Owner
23575
Lice #Electrical Contractor
rz- I S-2uzo J os +l pis
g Prime Contractor Date Print Name-Prime Contractor Company Name
'F`�si 3 ys . oLl 83
Print Name-Prime Contractor Phone Number-Prime Contractor
GlaG OSdO�(�
License#Prime Contractor
Approved for St.Lucie County by:
Signature-Electrical Inspector/BO Insp ID# Date
Inspector comments,limitations and restrictions:
2