HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPI," '�D FOR APPLICATION TO BE ACCEPTED
Date: \c�-o — 05-1�4 SCANNED Permit Numberl-�-�
St. Lucie Count
Y
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
5
Building Permit Application
Commercial - Residential
Address:
Legal Description:_ :9>AVa Ajo-- C LA I a: �K. r e-e t3 z z-
o o 0 to 0 --s
Property Tax ID #: Lot No. 1z
Site Plan Name: Blo ck No. Z Z-
Project Name:
Setbacks Front Back: Right Side: Left Side:
aitionaiworKtOnepertormea unclertnis permit- cnec
—Mechanical — GasTank — Gas Piping
Electric Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Constructiow $ 0 Utilitil
all tnat apply:
Shutters
Generator
Windows/Doors
Roof
Sq. Ft. of First Floor:
s: _Sewer _Septic Building Height:
X
Name
Address: ZS G1 (a C-%, A-CorRparfy:
Name:i"�'
Address:
City:
Zip Code: 73
Phone No
Fax: 3
. St a't' e:
City: Stat -
L
Zip Code: Fax: CN 114_
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
State or County License 2
5Z
SQ
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGI NEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone —
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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 commenc ed prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 r6que�ted 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financin& consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Ow _�15 r
,Jer/ Agent/ Lesse"& �acto
Signature of &hntractof)114gMMi!!HoIder
STATE OF FLORI?%J
STATE OF FLORIDA
COUNTY OF
COUNTY 00
The fWing instMent was aclknowledge�before me
this,�� day of. 261�� by
The fafong instNment was, acknowledged before me
this day of 20', by
Name of lfrson ac nowledging)
e of person ac now e gi�ng
ZN
atoure of Notacry Public- State of Florida
0 ot
(Signature of Notary Public- State of Florida
Personally Known ORProklueed4dentification,
)n
Personally Known !_Q9ar_0qy0UI _eA h. M �__ =_11
Type of ca r11WN MIL.,-
2
Type of Identification DAWN MILO
Ef
y CA
Produce WN 9 "I'c Statg Offl0fida
Produced Notar Public - State�No Florida
NOldly. PuIJIJc —Stale of RP,, 22.2017
';-:
"'Zi- 1MY Comm. Expires Mar 22,2017
41
M
� MY.COmm. Expires h1v I .
Commiss 'IE '��eal)
Commission No. 8# # EE 877571
NO E
'OFF
1,06alh National No!w
.. ......... __y
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 7/ZU14
win st
(Lot)
Lt
CO . P�
171
Jan.07.2015 06:27 PM j,,,- 173 Concreteo, Perj��ction 77234,-`764 PAGE
1/ -1.
Planning & Development Services
ion Division
IL Building & Code Regulati
COUNTY 2300 Virginia Ave
F L 0 R I D A Fort Pierce, FL 34982
772-462-2172 Fox 772-462-6443
CERTIFICATE OF TERMITE TREATMENT
CONSTRUCTION SOIL TREATMENT
PERMIT # JOB ADDRESS: 8596 Gallbe" Cir. P.S,L,, FL. 34952
BUILDER/CONTRACTOR:
PEST CONTROL
CONTRACTOR: Trusty'u Put runtrol, LLC PEST CONTROL
LICENSE# :JR183270
We, the undersigned, hereby certify that we have pretreated the above described construction for
subterranean termites in accordance with the standards of the National Pest Control Association.
Square feet if area treated- 1,30
Percentage of solution, O,Owl- -
Date of Treatment; January 6, 2015
—Footing
1"' Treatment
Re -Treat
—Driveway
11t Treatment
Re -Treat
—Other
__11t Treatment
—Re-Treat
Chemicals used: �_e_no,�"
Total gallons used, _2
Time of Treatment: T26 PM.
!!�_Slab
XXX V Treatment
—Re-Treat
—Pools
V Treatment
Re -Treat
—Perimeter for Final inspection ..... .... .
Signature of Exterminator
Ivate, 77jere must be a completed torm for each required ftwtment or re-tteatmentand this form must he on thejob
site to be plc*ed up by the Inspector at time of each inspection or the scheduled Inspection will fall and a f L—inspedlon
tee charged
FOC1 04, Z6 Cedificate Of PrOtective Treatment for prevention of termites, A weather reslstantJobs& Posting board
shallbeprovlaedlb, receive duplicate Treatment Car&firates�as each requ1redproW#ve, treatmentIs compleiW,
provAdIng a copy for ffie person the permit Is Issued to and anoiher copy for the bulldtny pemAt files. Me Trea4nent
Cettfflcate shall provide the product vW, Identity of the applicator, t1me and date of the trealment, We locatlan, "a
treated, cheirkal used percent concentration and number ofgallonsuse4 to establIsh a ven#able reratd of
pmtacfte treaftnent. if W sdl chemIcal banfer method for lennite prepen#on Is used, final exheflor treatment shall
be completed prior to finalOulldng approval
St Lucie County requires for the final Inspection for 'COr 8 Permanent Sticker to be placed on
the electrical panel box coverr listing all the treatments and dates of applications.
RECEIVED JAN 08 2015
SUPERMIX TM
vl�; TTM+
'The On Time Concrete Company"o
CENTRAL CONCRETE SUPERMIX, INC.
CONCRETE DISPATCHERS:
MIAMI-DADE: (305)264-7101
DEERFIELD: (954) 480-9333
BLOCK PLANT: (305) 805-3226
WWW.SUPERMIX.COM
MAIN OFFICE: 4300 S.W. 74th Ave. - Miami, FL 33155
pwwr=m teinrN or_o_,aorzr) . r:A ejr)r, e_)CZ-7 r%0_Q0
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CUSTOMER
'DELIVERY TICKET
T DATE
J(3�])JfA_1I__: I-N
1., 1 j
Vol/ 15
SERVING MIAMI-DADE, BROWARD, PALM BEACH, MARTIN & ST. LUCIE COUNTIES
SOLDTO
DELIVERY ADDRESS
CONC I F-,*!E'TE PFPT,'T-.'CT10[,
3 %-4 HOR1,11 GH(jf�%'E 0
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QUANTITY DESCRIPTION
PRICE
----------
UNIT EXTENSION
'e,710'2 F��'�'Gtft f-'sp,
12�
CV
J,
i'-Tl Y F E
MINUTES ALLOWABLE TIME*
EXTRA UNLOADING TIME CHARGE
PER MINUTE
X $1.00
*6 MINUTES PER CU. YD. ALLOWED SHORT LOAD CHARGE
SLUMP
THIS DELIVERY TOTAL CU. YDS.
AMOUNT
OF YOUR ORDER FOR
CU. YDS.
TAX
CUSTOMER OR HIS AGENTASSUMES FULL RESPONSIBILITY FOR STRENGTH AND/OR
PERFORMANCE OF ANY CONCRETE PLACED ABOVE DESIGN SLUMP OR WHEN
WATER IS ADDED. WATER ADDED D YES U NO GLS.
TIME ARRIVED ON JOB
" STARTED UNLOADINGT
FINISHED UNLOADING
LEAVING THIS JOB
"TOTAL TIME
tj
SUBJECT TO THE TERMS, CONDITIONS AND "CAUTIOW1 WARNING LISTED ON BOTH THE
FRONT AND BACK OF THIS TICKET.
TRUCK DR I acknowledge that I have received and accepted the materials listed on this ticket. I
understand and agree to the te rr s on both the front and back of this ticket.
1*r1":'_"1 RECEIVED BY: X
CONTROL 20 LOADING POINTS AT 16 LOCATIONS TO SERVE YOU BETTER
(0�r MIAMI - DOWNTOWN MIAMI - WEST MIAMI - AIRPORT - OPA-LOCKA - MEDLEY - PERRINE - PEMBROKE PINES rTc
0 7 65, "A DEERFIELD - BOCA RATON - RIVIERA BEACH - STUART - W. BROWARD - FT. PIERCE - E. BROWARD - DELRAY
PRODUCERS AND SUPPLIERS OF QUALITY READY MIXED CONCRETE AND CONCRETE BLOCK NRMCA
DELIVERY COPY ;V7_.7=__