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HomeMy WebLinkAboutSUBMITTED PAPERSDATE FILED:'�P PLAN REVIEW. E: d a .O O RECEIPT NO.: CkArfy S PERMIT NUMBER VA 4 s — Od I �D CONCURRENCY FEE: RECEIPT NO.: CERT. CAP. NO.: ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Avenue /+9 Ft. Pierce, FL 34982-5652 (� 772-462-1553 v APPLICATION for BUILDING PERMIT CERTIFICATE of CAPACITY/ZONING COMPLIANCE PROJECT INFORMATION 1. LOCATION/SITE ADD /RESS: - l o / C z 9 �% • %�/f e r e, T� 3 �S� 2. PROJECT NAME: / VG �� 0, -V SITE PLAN NAME: '©,b ,eges ;.den C e 3. PROPERTY TAX ID #: oZ / O 5 6O — O 3.?a--gw. 4. LEGAL DESCRIPTION (attach extra sheets if necessary): 5. 9. 10. PLAT BOOK 6. PAGE NO. PARCEL SIZE (ACRES/SQ FT.): 3 7. BLOCK NO. i a' LOT DIMENSIONS: 8. LOT NO. 1 /"12 19-4 COMPLETE DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY: do'n c'C' 00JU) e dze I'd,) jL,2ti 8 L) Ck da &./e 11. ) SETBACKS (ACTUAL) FRONT: BACK: RIGHT SIDE: LEFT SIDE: V" TYPE OF CONSTRUCTION (Check all appropriate boxes) ] NEW CONSTRUCTION [ ] EXPANSION/ADDITION [�] RESIDENTIAL [ ] COMMERCIAL [ ] OTHER (SPECIFY) DESCRIPTION OF PROPOSED USE: SQ. FT OF CONSTRUCTION: I f) 6-0 VALUE OF CONSTRUCTION: $ ��� O QQ 0 O [ ] INTERIOR RENOVATION [ ] INDUSTRIAL 15. SF. FT 1st FLOOR: The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a RECORDED Notice of Commencement must be submitted with this application. SLCCDV Form No.: 001-02 SCANNED BY St. Lucie County UPDATED 6/25/09 /CC vd341.0 1 '-*1�0S 1 0© OWNER INFORMATION NAME: _�t ADDRESS:. O 3 !;�_ CITY: &c r G e PHONE (DAYTIME): (_) STATE: /- _ ZIP: Email: /i%b I o . J,;/? qJ cJ 692,3 X.,C(oo •�o IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: �( ADDRESS: �O 7 7 �f CITY:, �/ % C / STATE: �� ZIP: pp u 4/ x1sa PHONE (DAYTIME): � .� CONTRACTOR INFORMATION ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #: BUSINESS NAME: QUALIFIERS NAME: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTIME): (_� FAX NO. Email: ARCHIT/BNGINEER: ADDRESS: CITY: STATE: ZIP: PHONE (DAYTHAE): BONDING COMPANY: ADDRESS: CITY: STATE: ZIP: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP: IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will be voided and returned to you by mail. CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application. St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. STATE OF FLORIDA , STATE OF Fl COUNTY OF S%r. LoC\'k COUNTY OF The foregoing instrument was acknowledged before me this. day of �l V1� 20 �t1 , by � a v.a► � � �l a%1'� who is personally known or has produced W %L%- \93—�� arO3 4bas identifica SIGNATURE The foregoing instrumeN me this day of by who is personally known Signature of Nota Notary Pcb�' _, .1 &C 16, "1s� Signature of Notary was acknowledged before 20 , or s produced as i entification Commission No. C0 a -National Notary^"' Commission No. (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. Adikk OFFICE USE ONLY BP #: !'146-a4 SECTION TOWNSHIP .S RANGE — OE, MAP NO. J� ZONING R !� _ L� LAND USE D t \ . LOT CVG % TAZ NO. FLOOD ZONE FIRM MAP # ISr FLA ELV MAX HGT CONST TYPE OCCUP TYPE MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC Before 1/1990 LOT OF REC After 1/1990 LOT SPLIT REQUIRED LOT SPLIT APPROVED REPORT CODE ._ HABITABLE O RADON FEE PERMUI' FEE LIBRARY IMPACT FEE PUBLIC BLD IMPACT FEE CORRECTION C BLD CT fFEE ERAL PARKS IMPACT FEE SCHOOL IMPACT FEE ROAD IMPACT FEE CREDIT Y N LAW ENF IMPACT FEE FIRE/EMS IMPACT FEE DRIVEWAY REQUIRED Y N DRIVEWAY FEE ADMINISTRATIVE VARIANCE FEE SPECIFY SUBS REQUIRED MECHANIC ROOF `� ELECTRIC GAS PLUMBING NON -CONFORMING LOT OF RECORD FEES MISCELLANEOUS FEES DATE SENT TO ADDRESSING: REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED CP9- I Il // DCOMPLETED Colol 14 INITIALS / JOSEPH E. SMITH, CLERK QL THE CIRCUIT COURT — SAINT LUCIE COjjjTdft FILE # 3963755 OR 40 PAGE 2206, Recorded 06/11/201 q WI :11 AM Permit No.\'A0G QUO, �0 Tax Folio No. StateofFlorlda County of St Lucie The undersigned herebygives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following Information Is provided in this Notice of Commencement. lof Pro�er�r _let address If available): egal /J /7dDesMption 7 ✓1/ 5 % s�' 1'pi'�i^cf��L/O,I"fZii3jt� General description of Improvement: Owner Information o e inform do Lessee contracted for the improvement: Name _ [�� �� Address __ 3o IL 9.-3 9/— Interest in property: Name and ad�ess fee simple itl holder (if different fro Owner Ii ed bov) , Contractor's Name: 0VJYlC 1 ode Contractor Address: Phone Number. Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ Name and address: Phone number: Lender Name: Phone Number. Lender's address: persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 719.13(1)(a)7.,,Florida Statutes: Name: Phone Number: Address: in addition to himself or herself, Owner designates of Llenors Notice as provided In Section 713.13(1)(b); Florlda Statutes. Phone number of person or entity designated by owner to receive a copy of the Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WiTH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge an ell . (Signature of Owner or Lessee, or Owners Lessee's Authorized Officer/Director/Partner/Manager (S(gnatory's Title/Office) fore DindInst4e wadged before me this day ayy� � , 20 � , By t 7 �?}�` as O Vl V\!Kf for fn R.% f,d Y Name of Person Type of authority (e.g.officertrustee) Party on behalf of wA—om instrument was executied _ Personally known,&,or produced identification_____ (Signature of Notary u �}�I (Print, Type, or Stamp r ¢k9(Ijd, Name old i b�"[C<"I o�o� �; Notary pub c • la Florida My Comm. Expires Dec 16, 2016 'od Commission # EE 858761 fR ( Bonded Through National Notary Assn. Type of Identification produced STATE aF FLORUDA ST. LUCIE� COUNTY THIS IS TO CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF THE ORIGINAL. a.J%Figjc S PSI I I. y E11L i- r a, 66 �� � o �-(X_Ao PLANNING & DEVELOPMENT SERVICES DIVISION BUILDING & CODE REGULATIONS DIVISION 2300 Virginia Ave Fort Pierce, FL 34982 BUILDING PERMIT U CONTRACTOR SUMMARY will be using the following sub -contractors for the (Company/Individual Name) ,, / project located at ® NU Pr & i C_ e , 7G- 3 L%� (Street address or PropertyTax ID #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical Plumbing HVAC/ Mechanical Roofing Gas OFjIIC�T,SQNIY PERMIT ISSUE DATE: NUMBER: I qjjw(�n 16 PERMIT# ISSUE DATE �-60j I I PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida C74cation Number If a plicable): have agreed to be the ( �mpany ame/Individual Name) I � Sub -contractor for (Type of Trade) C (Primary Contractor) For the project located at (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REOUIRED Business Name: Address: O ® i 3 7— City/State/Zip: Phone: 77,2-) email: 4o de J6J hoo. Cna-1 SIGNATURE PRINT NAME DATE STATE OF FLORIDA, COUNTY OF THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF , 20 BY WHO IS PERSONALLY KNOWN OR HAS PRODUCED AS IDENTIFICATION. (STAMP) SIGNATURE OF NOTARY PUBLIC PRINT NAME'OF NOTARY PUBLIC SLCPDS: 12/16/2013 PLANNING & DEVELOPMENT SERVICES Building & Code Compliance Division BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification have agreed to be the (Corn � y Namp/Individual Name) tt f Sub-contractor for (Type of Trade) (Primary Contractor) For the project located at DO (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by filing a Change of Sub -contractor notice. (Form: SLCCDV (No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) NOTARIZED SIGNATURES ARE REQUIRED Business Name: Address: City/State/Zip: Phone: SIGNATURE PRINT NAME STATE OF FLORIDA, COUNTY OF email: DATE 0 THE FOREGOING INSTRUMENT WAS SIGNED BEFORE ME THIS DAY OF 920 BY WHO IS PERSONALLY KNOWN OR HAS PRODUCED SIGNATURE OF NOTARY PUBLIC SLCPDS: 12/16/2013 AS IDENTIFICATION. PRINT NAME OF NOTARY PUBLIC (STAMP) a,'=tf' Plan ning-& Development Services Department Building & Code. Regulations Division 2300 Virginia Ave _ Fort Pierce, FL.34982 772-462-1553 .. ---- Owner B:uildea--Afdawlt -Electrical Conlracfing __ _ ._-_ : - - ------ DISCLOSURE STATZMENT . F.S..489.503 (6)EXEMPTIONS State law requires electrical contracting to be done by -licensed electrical contractors.'You have e_ applied -for a = permit -under an exemption torthat law The exemption allows you, as the Owner. ofyour prope to act as oyur own - electrical contractor even though you do not have a license. You may install electricalwiring for a faun outbuilding or.a single-family or _duplex residence. You may install electrical wiring in a enm,�rcial bu)d�tnghe aggregate-.— --- - — -- _------- --- -construction cos s of w-Yncfi are under $75 000_ The home-orbuildingmust be.for.youx _ownuse nnd-occupancy: It inay not: be biiilt.for sale orlease.. ;If youaeIl or.lease. more ,than one building you have wired yourself within 1 year after the construction is complete, the law will presume that you built it-for;sale or.lease, which.is..a.vio.lation ofthis exemption. You maynot hire an .unlicensed person as your electrical contractor. Your.. construction shall.be done according to building codes.and zoning. regulations. It is your responsibility.to make sure that:people;employed by you have licenses required by state law and by county or municipal licensing ordinances. Failure to do so 'may result in a .liability for you! To qualify. for this exemption under this subsection, -an owner must personally appear and sign the building permit application. .I hereby acknowledge that I -have read and understand the above disclosure .statement and that I further understand. that.any-violation-of.-the terms .of the owner/builder exemption shall be reporied by the Community Development Director to the Florida State Department of ProfessionaLRegulatiiton. Signed and acknowledged on this. day of 20 OWNER/BUILDER SIGNA - STATE OF FLORIDA COUNTY OF _ The foregoing instrumentwas acknowledged before me this day of \i tines ,'20 :by Oha 0�1 J , who is personally known to me or has produced \ d \q3 -14, Qxe U as identification. V y1 (Seal) �Signatu�reofotai Print name of Notary Title: ai He DEANNA GIVENS Commission Number EA%46) 2�0 ; Notary Public - State of Florida , =My Comm. Expires Dec 16, 2016 $LCP.s Rq Z3�Q�r�t�ission # EE 858761 O �FL � Bonded Through National Notary Assn. St. Lucie - e rcai tr cting Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772)462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 (7) EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to.act as your own contractor even though you do not have a license. You must provide direct, on -site supervision of the construction yourself. You may build or improve farm outbuildings, a_ one -family or two-family residence or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances, building codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on how to meet the minimum code.. Initial Q nl I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial I understand that if I compensate any person or company for work performed they are required to be licensed in this jurisdiction. If for some reaso_ n they do not possess.a license,.I may be_responsible and liable for th _ cost of the license. Initial I understand that if any person that. is unlicensed and uninsured gets injured on my construction project - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related medical cost, which could include,loss of wages during recovery from their injury. Initial To qualify for this exemption under this subsection, an owner must personally appear and sign the building permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owner/builder exemption shall be reported by the Building and Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this day of of 20 Owner/Builder Signature STATE OF FLORIDA COUNTY OF S' , V , The foregoing instrument was acknowledged before me this a day of : y IN 4 , 20)!A_, by car+O. \ O ,R, - who is personally known to me, or who has produced V3 "� G — \dl - '1 QCc 3 O as iden _ �Siat=ureofotary �qh G 1 t h .`,l,,,rY r,,,,, PRPU@ ;,_+• «*� : DEANNA GIVENS Notary Public - State of Florida Type or Print Name of Notary . •e :sue • « . My Co Expires Dec 16, 2016 Corn Title: Notary Public Commission Number F 5 F��p•%, 1 F ,�• i si n # EE 858761 Bonded Through National Notary Assn. SLCPDSD Revised 07/22/2010 SIGNATURE OF NOTARY PUBLIC TYPE OR PRINT NOTARY rackafISSION NUMBER DEANNA. GIVENS No�� Public - State of Florida �;� Expires Dec 16, 2016 i My'GOmm • ' oe� Commission # EE 858761 °;,;,` Bond ,��` ed Through National Notary Assn. SLCPDSD Revised O8/24/2010 1 PLAI!TIYING AND DEVELOPMENT SERVI ES DEPARTMENT BUILDING AND CODE REGULATIONS DIVISION 2300 VIRGINIA AVE FORT PIERCE, FL 34982 (772)462-1553 Fax (772) 462-1578 PERMIT RENEWAL REQUEST PE IT NUMBER: l /QC7 ��ADDRESS: 1, �1 —y:JU -�-- am requesting that the above permit be renewed. I understand that I mus schedule and pass all required inspections for the permit to be finaled. Further, I understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a passing inspection during any six month period during the renewal period. Justification he OWNER/BLDR OR C NTRACTOR SIGNATURE /00/i) !a /d "1:21-C Print Name STATE OF FLORID ( etet DATE 20 ILS— OR HAS PROVIDED AS IDENTIFICATION. t� ST TE OF FLORIDA, ounty of ,•`''".. a"'. ANGELA M HUFF ••41 '+1'4� Notary Public State ql Florida - SIGNATURE OTARY ' - Commisalon # FF 234730 37 My Comm. Expires May 27, 2019 `�• eondedth y rough National Notary Assn. FOR OFFICE USE ONLY: Number of Open Inspections: Total Inspections: (Divide open by total to get % of open inspections) Percentage: Original permit fee: x % open = $ Renewal fee Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee) Revised 7/21/2014 -/ n "v e �'!q3 �44 CONCRETE i 503 NW 9th St., Okeechobee, '' LEFT PLANT ARRIVED JOB START UNLOADING MIXER WAITING TIME ADDITIONAL TIME ON JOB MINUTES CHARGE 1 RETURNEDIPLANT LEFT JOB FINISH UNLOADING OVERTIME'.. _MINUTES ADDITIONAL RATE OF X $ ._ PER MINUTE CHARGE 1 TOTAL ROUND TRIP TOTALATJOB UNLOADING TIME _ -- DELAY TIME TAX1 OVERTIME CHARGE SPECIAL INSTRUCTIONS' ✓ biz Ap Q c, Jl 04, 0 ECHO 3EE ASPHALT & RI kDY MIXED 4� CONCRETE INC. 503 NW 9th St., Okeechobee, FL 34973, 863-763-7373 • Fax 863-763-7379 SOLD TO: SHIP TO: GC Sf fl 3 elA- WARNING PROPERTY DAMAGE RELEASE -� (TO BE SIGNED IF DRWERYTOBE MADE INSIDECURB LINE) IRRITATING TO THE SKIN AND EYES See Terms & Condition, Excessive Water is Detrimental to Concrete Performance ' Contains PorilOnd:Cement. Wear Rubber Boots and Glov fS., Dear Customer; Thedriver of .this truck is presenting this PROLONGED CONTACT MAY CAUSE'SURNS'. AvOWCtrt{fifaet Wig E RELEASE to you foi your signatu a rs of tho opfnlon that t to H2O Added By RequeSt/Authorized, By and Prolonged Gonda($ with Skin. In; case of Contact With SWt Of Eyes size and weight of his truck may possibly cause damage to the. premises and/or adjacent property it he places the material w GAL :n Plush Thoroughly Waite Water. in this toad whore you desired it. It is our wish to help you -ati-, _' . iww* tc`. §u.. . If i(fitat7ort f631643, Oet Medical Attention, in every way that We can, but in order to do this the drover isc�c KEEP CHIUDREN AWAY, requesting that you sign this RELEASE relieving him and this supplier from any responsibility from any damagethat may CONCRETE fS A PEWSHABLE COMMODITY AND $EwMES TH5 occur to the premises and/or adjacent property, buildings, PROPERTY OF THE PURCHASEIR40N LEAVING PLANT. ANY stdowalks, driveways, curbs, etc. by this delivery of material. -THE CHANGES OR CANCELLATION OF ORIGINAL INST3;UGTION MUST SE Further as additional consideration, the undersigned agrees the driver of dus track and to indemnify and hold hall TELEPHONED TO THE OFFICE BEFORE LOADING STARTS. itssupplier for any and all mage to the promises and/or damage - A $30.CrQ CCiefr/IGe ChR'ge Wlll be GfY11ec4erYrf-kd R2tufit.tj CfiDdiCS• adjacent property which may be claimed by anyone to. have arisen out of delivery of this order. LOAQRECEIVED BY: 6 MINUTES' IYD IS ALLOWED TO UNLOAD THIS TRUCNf. e �` $80.0D PER HR. WILL BE CHARGED THEREAFTER. X �— — — __-- -- - -- --_-- --- --�-- MIXER WAITING TIME LEFT PLANT ARRIVED JOB START UNLOADINq ADDITIONAL CHARGEI ADDITIONAL CHARGE 1 TAX I W� TIME ON JOB —MINUTES OVERTIME MINUTES RATE OF X $ PER MINUTE _ $ — OVERTIME CHARGE RE. URNED PLANT LEFT JOB FINISH UNLOADING TOTAL ROUND TRIP TOTAL AT JOB UNLOADING TIME DELAY TIME SPECIAL INSTRUCTIONS: General Terms, and Conditions of Sale 1) Purchaser Notice: Purchaser agrees to provide Seller reasonable notice orthe -time and rate of deliveries under the contract. Quoted prices are based on deliveries leaving Sellers plant location between 7:OOAM and 4:OOPM weekdays. Special arrangements will be required for times and days other than previously stated. 2) Full compressive strength is obtained with 28 days, when tested in accordance to A.S.T.M. using water cement ratio to produce a slump not to exceed 6 inches. 3) If the purchaser adds water exceeding the recommended slump or other materials to the concrete mix Seller is no longer responsible for either the slump or the strength of the concrete delivered. 4) Concrete quantities are based upon the absolute volume method of determining yield. 5) Any deliveries place other than from paved areas the purchaser agrees to provide stable roadways permitting access of trucks to point of delivery under the equipments own power. Seller reserves the right to refuse deliveries if stable roadways or areas are not provided. All liability or damages to sidewalks, driveways, underground utilities or other property beyond the curb line shall be the exclusive responsibility of the purchaser, Purchaser agrees to indemnify the seller against all liability loss and expense incurred as a result of such delivery including damage to seller's equipment. 6) A Maximum of 60 -minutes per 10 yard load is allowed for the completion of the delivery time of discharge. Delivery vehicles held longer than 60 minutes per 10 yard load will be charged to the purchaser at the Seller's current rate or that type of vehicle. 7) Delivery will be provided at the Seller's best rate of production. The purchaser agrees to hold the seller harmless for loss, damage or delay due to strikes, labor difficulties, fires, weather, accidents, war, delay of carrier or from any other causes beyond the sellers control including manufacturer of the materials herein mentioned. 8) Any purchaser's claims or exception will be deemed waived unless made to seller within 3 days of the time of delivery. The purchaser shall give seller full opportunity and unrestricted access to investigate claims or exceptions. Seller's liability shall not exceed the purchaser's price of the material or products in any event for the claim made, 521 NW Enterprise Drive • Port St. Lucie, Flor' , {4986 - (772) 924-3575 . (772) 924-3580 (fax) Per Av2, NAT%0:,tX IN -PLACE DENSITY AND WATER CONTENT OF SOIL AND SOIL AGGREGATE BY NUCLEAR METHODS (SHALLOW DEPTH) - ASTM 6938 Project: 1707 North 37th Street Project ID: 14-1542.00 Address: Fort Pierce, St. Lucie County Report ID: D-0001 Client: Donald Noble Date: 6/30/2014 Permit No: Field Tech: Mark Barkley Test Mode: Direct Transmission Area Tested: Garage Addition Soil Description: brown fine sand, trace slit, trace rock nodules Proctor / LBR ID: P-1 Max Density (PCF): 112.0 Opt Moisture (%): 10.0% Test Standard: D 1557 E s: 1 1 1 1 Compaction. Required (%): 95.0% Probe Depth (in) Elev Wet Density (PCF) Dry Density (PCF) Moist. (%) Compaction Location % Results Southwest 12 0-1 118.2 110.4 7.1 % 98.6% Pass Center 12 0-1 118.6 j 110.2 7.6% 98.4% Pass Northeast 12 0-1 119.8 111.4 7.5% 99.5% Pass Testing Gauge Information: Manufacturer: Troxler Model: Density Standard (DS): 2363 Remarks: Testinci Completed Below Slab Grade -egena for Llevatlon: 3R = Proofroll 3L = Springline 3G = Subgrade 3C = Basecourse rOP = Top of Pipe 1, 2, 3 = 1st, 2nd, 3rd Lift FL = Final Lift BG = Below Grade BOF = Bottom of Footing FG = Finished Grade 3430 S/N: 36442 Moisture Standard (MS): AA 635 RED' TV*,* IS' 0'telfna 8@@ dnc. *'.0 I!P A# 0 r ; r � mtvafd W.�ftftp(E' : �► P�@ IonW Egginggp' '5 Test report shall not be reproduced, except in full, without the written approval of GFA International OWL&* Environmental • Geotechnical . Construction Materials Testing . Special and Threshold Inspections . Plan Florida's Leading Engineering Source www.teamgfa.com Time of Treatment: ,� 0 Slab 2300 Virginia Ave Fort Pierce, FL 34982 772-462-2172 Fax 772-462-6443 CERTIFICATE OF TERMITE TREATMENT CONSTRUCTION SOIL TREATMENT PERMIT #: 11-100 _0D/- JOB ADDRESS: BUILDER/CONTRACTOR: PEST CONTROL CONTRA( PEST CONTROL LICENSE 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: Id 00 � Chemicals used: QAA 9005C Percentage of solution: 0, b Total gallons used: Date of Treatment: / " ) Y Footing 1st Treatment 1, Treatment Re -Treat Re -Treat Driveway -Pools,;- ist Treatment 1St Treatment Re -Treat - Re -Treat Other. - Perimeter for Final Inspection 1st Treatment Re -Treat Signature of qeinator Note: There must be a completed form for each required treatment or re -treatment and this forg�mrl�tJe�� the job site to be picked up by the inspector at time of each inspection or the scheduled inspection h/45,1 il�if re %pection fee charged. Cie Co, ., FBC104.2.6 Certificate of Protective Treatment for prevention of termites A weather resistant jobsite posting board shall be provided to receive duplicate Treatment Certificates as each required protective treatment is completed, providing a copy for the person the permit is issued to and another copy for the building permit files. The Treatment Certificate shallpro vide the product used, identity of the applicator, time and date 'of the treatment, site location, area treated, chemical used, percent concentration and number of gallons used, to establish a verifiable record of Protective treatment. If the soil chemical barrier method for termite prevention is used, final exterior treatment shall be completed prior to final building approval. St Lucie County requires for the final inspection for CO, a Permanent Sticker to be placed on the electrical panel box cover, listing all the treatments and dates of applications.