HomeMy WebLinkAboutSUBMITTED PAPERSPlanning & Development Services
Building & Code Regulations Division
2300 Virginia Ave.
Fort Pierce, FL 34982
(772)462-1553
SPECIALTY PERMIT APPLICATION
❑ Electrical ❑ Plumbing ❑ HVAC ❑ Fence
❑ Shed E�rDemolition ❑ Gas ❑ Siding
Seepage 2 for instructions and additional paperwork required for specialty permits
1. Location/Site Address: r� ✓�5 — ����1 L�
2. Parcel ID Number: s C41 " -S" 00 a
187cc t%Se
Only
.Section]
Township
Range
Map Page
Zoning Ian
Use
Initials
3. Complete Description of Project or Work: �J
4. Owners Information 77 / 5. Contractors Information
Name: l Ili l c c' U A, 7`!� FL Reg/Cert #:
Address: J _ /�/ - � � a 1 Z 6t9-7 County Cert#: 6 j .�
City: CST % State: Business Name:' ��,� , �j 11ityAy1`low
Zip: Phone: �` '� Phone:, Fax:3 o3
6. Value of Construction: $ e
I
OWNER'S AF IDAT rti tt of the information contained in this application is correct at ork will be done in
e O Dance a licable laws regul g nstru oning.
PRINT CONTRACTOR NAME SIGNAT WNER OR CONTRA
STATE OF FLORIDA, COUNTY OF G� 1 ` I — r
ACKNOWLEDGED BEFORE ME THIS � J DAY OF 20 't �. BJY 1�� � �[
WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED 1 L I .L e
AS ID IFICATION.
OF NOTARY
COMMISSION NUMBER
TYPE OR PRINT NAME OF NOTARY
pAYI(N MILONE
MY CO ION # DD 852587
EXPIRES: March 22, 2013
Bonded Thru Notary Public Underw cars
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $7500.00
Revised 04/26/2010
NOTICE TO OWNER: F) .E TO RECORD A NOTICE OF COMMENCEM rIAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INIEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
EXEMPT: A/C -HEAT REPLACEMENT WITH CONTRACT UNDER $5,000.
INSTRUCTIONS
Please complete all information in the space provided. All information must be printed (use black or blue ink
only) or typed. This permit application is to be used only for those activities that are not otherwise included
under a primary building permit. This application may not be used for any activity that includes structural
alteration. The information to be provided with this application includes:
1. Location/Site Address
2. Parcel ID Number
3. Description of Project or Work Activity
4. Owner Information
5. Contractor Information
6. Value of Construction
Indicate the street address or general location of
property where the building activity is taking place.
Indicate the tax identification number of the
property where the building activity is taking place.
Fully describe the activity to take place.
Indicate the name and address of the owner of the
property on which activity is taking place.
Indicate the State of Florida registration number (if
applicable), St. Lucie County contractor license
number and the name of the business doing the
work.
Indicate the total value of the work to take place.
Total cost of construction includes all current retail
material and labor costs associated with the
building/construction activity. Construction value is
used to determine the permit fee. 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.
❑ Gas Attach 2 piping schematics with tank size,location, and BTU of each appliance
❑ Shed: Attach 2 plot plans, 2 copies of DCA letter and plans, 2 anchor specifications
❑ Fence Attach 2 plot plans showing location of fence height of fence and type of fence
❑ Siding Attach 2 copies of manufactures specifications
❑ IHVAC Attach 2 residential energy studies, 2 manual J calculations. 2 sets of duct layouts for
new system or full replacement
This application can be submitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce,
FL 34982. All permit applications must be filled out completely before submission. No applications will be
accepted for processing after 4:30 P.M. For assistance in completing this application, please call (772)
462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday.
NOTE: Emergency electric service change out inspections will not be performed after 3: 00 PM without
special arrangements and additional fee paid.
Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261.
i�LVLi v- - .U1 U`1. 1 / ! r r LL 7JU 1.)0 t Cn L -MULL I lUIY
12/09/2010 16:44 7724622094 ST LUCIE COUNTY PAGE 08/08
ST LUCIE COUNTY HOUSING DIVISION
437 N. 71h Street
Fort Pierce, FL. 34950
REQUEST FOR QUOTEIPROPOSAL
DICE DATE: Wednesday December 15, 2010 at 12.00 p.m.
CONTRACTOR INFORMATION: COUNTY CONTACT INFORMATION:
Com an Name: L. E. B.DEMOLITION LNC. Please complete and return this form to:
Address: 12805 SOUTH INDIAN RIVER DR. 9
Glty/state/Zip: JENSEN BEACH, FL
Contact Person: LEE BECKFORD
Phone: 772 216-1284
Fax: 772 229-3036
Signature:
Title: PRES.
Date of Quote: 12 / 15 / 2010
Diana Wesloski, Program Specialist
437 N. 71n Street
34957 Fort Pierce, FL 34950
P: (772) 462-1290
F: (772) 452-2855
wesloskid@stlucieco.org
THIS IS NOT AN ORDER
Quote prices shall be stated in units requested and shall remain firm for ninety (90) calendar days.
The County Is exempt from Federal Excise (059-6000835) and Sales Tax (#86-02-017739-53C)
Permits are to be applied for within 2 days of the notice to proceed. Work is to be completed within 2 weeks from the date
the ermit Is Issued. Price must include all permits and fees associated with com ietin the scope of work.
PROJECT LOCATION; St. Lucie County Neighborhood Stabilization Program (NSP) Property
5715 Cassia Drive, Fort Pierce, Florida
Description:
Single family home demolition and safe, legal, disposal of all materials and clean up of job
site. Demolition includes abandonment of the septic tank and removal of all foreign matter,
contaminated soil and debris.
Total Price $ 4 , 218.00
I- -
to
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
ASBESTOS NOTICE
Asbestos Notice To Contractor
01/18/2011
L E B DEMOLITION & CONSULTING CO
BECKFORD LEROY EDWIN
12805 S INDIAN RIVER DR
JENSEN BEACH, FL 34957
RE: Building Permit Numbe 1101-0120
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes, and
to notify the Department of Environmental Protection of any intentions to remove asbestos,
when applicable, in accordance with state and federal law.
Signature
Date
t'(tl:t1Vt1) 01/1t7/Lb11 2b:4/ /1122'JJ03b
01/11/2011 TUE 9:22 FAX 77246130
LEB DEMOLITION
2001/001
STATE OF FLORIDA
�} DEPARTMENT OF HEALTH
tONSITE SEWAGE TREATMENT AND DISPOSAL
SYSTEM
CONSTRUCTION PERMIT FOR: OSTDS Abandonment
APPLICANT: (LEB Demolition)
PROPERTY ADDRESS: 5715 Cassia Dr Fort Pierce, FL 34982
LOT: 30 BLOCK: 78 SUBDIVISION: Indian River Estates
PERMIT #: 56-S F-1294554
APPLICATION #:AP989335
DATE PAID:
FEE PAID:
RECEIPT #:
DOCUMENT #: PR831290
PROPERTY ID #; 340261002550008 [SECTION, TOWNSHIP, RANGE, PARCEL NUMBER)
[OR TAX ID NUMBER)
SYSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS AND STANDARDS OF SECTION
381.0065, F.S., AND CHAPTER 64E-6, F.A.C. DEPARTMENT APPROVAL OF SYSTEM DOES NOT GUARANTEE
SATISFACTORY PERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS,
WHICH SERVED AS A BASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE
PERMIT APPLICATION. SUCH MODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
ISSUANCE OF THIS PERMIT DOES NOT EXEMPT THE APPLICANT FROM COMPLIANCE WITH OTHER FEDERAL,
STATE, OR LOCAL PERMITTING REQUIRED FOR DEVELOPMENT OF THIS PROPERTY.
SYSTEM DESIGN AND SPECIFICATIONS
T [ 900 ] GALLONS / GPD
A ( J GALLONS / GPD
N [ J GALLONS GREASE INTERCEPTOR CAPACITY
K [ ] GALLONS DOSING TANK CAPACITY [
D [ ] SQUARE FEET
R [ ] SQUARE FEET
A TYPE SYSTEM: [ J STANDARD
I CONFIGURATION: [ ) TRENCH
N
F LOCATION OF BENCHMARK: N/A
I ELEVATION OF PROPOSED SYSTEM SITE
E BOTTOM OF DRAINFIELD TO BE
L
D F -
0
T
H
E
R
CAPACITY
CAPACITY
[MAXIMUM CAPACITY SINGLE TANK:1250 GALLONS]
)GALLONS @( )DOSES PER 24 HRS #Pumps
SYSTEM
SYSTEM
[ ] FILLED ( ) MOUND
[ ] BED [ j
)[ABOVE/BELOW] BENCHMARK/REFERENCE POINT
)[ABOVE/BELOW) BENCHMARK/REFERENCE POINT
1 n Wuln v; t u.uu J INI:HY:J EXUAVATIVN REQUIRED: [ ) INCHES
Have the tank abandoned in accordance with the following procedures.
(a) The tank shall be pumped out.
(b) The bottom of the tank shall be opened or ruptured, or the entire tank collapsed so as to prevent the tank from retaining
Have the system inspected by the health department after it has been pumped and ruptured but before it is filled with
id and covered and
The tank shall be filled with clean sand or other suitable material, and completely covered with soil.
SPECIFICATIONS
BY: James C Duncan
TITLE: Environmental Specialist
II
APPROVED BY:
TITLE: Environmental Specialist II
St. Lucie CHD
James C Duncan
DATE ISSUED:
01/10/2011
EXPIRATION DATE:
04/10/2011
DH 4016, 08/09
(Obsoletes all previous
editions which may not be used)
Incorporated:
64E-6.003, FAC
Page 1 of 3
v 1.1.4
A2989335 SE-1
KRK Enterprises, Inc.
P.O. Box 135�1
Fort Pierce, FL 34979.3571
GREEN PUMPMG B PWMONG'ft'll %
SR 093-1151 • CFC 1426828 -W •
"Committed to Exceeding Your Expectations with Service"
❑ C.O.D. XBILLING
❑ CASH
❑ CHECK
❑ Amount Paid
❑ Credit Card #
Expiration Date
Zip Code
�Scurity Code
Auth. #
1 4�Q RR�
1 if �!•�.
= -.1 , , :') I -K
St. Lucie County 772.595.6254
Marlin County 772.287.5453
Indian River County 772.567.8721
Okeechobee County 863.467.2640
Highlands County 863.655.1414
Southeast U.S. 800.330.7686
Fax 772.461.3077
www.krkservices.com
I he urid ersigne:;VACLIUM TRUCK SERVICES
right) from Chew na i �.�,,.. •i tin -.�� .. - . c �. _ . � Houuy S or H hours TRK #
-ij Septagt - J Undercover 2.ro L;d gallons I
• --
r ---J9allons
' j Dump Fees ❑ Sand Removal - S U Screen Cleaning
• — -- —) ❑ OSTDS Certification - S ❑ Other - S ❑ OSTDS Inspection
❑ •
e e ❑ Repau - 1 Ll Instaliation - N ❑ Reiuv - T
gli-Septic Tank ❑ Grease Trap
b`@ Normal Level
❑ Additional Loads Of Septic Sand 1 Loads
❑ Outlet Screen
p Septic Tank ❑ Grease Trap
❑ Level Above Normal
❑ Electrical Repairs - Subcontracted ❑ Septic Tank Lid
❑ RTA/Riser/Lid (s)
❑ Septic Tank structurally sound
❑ Deflection device installed
❑ Grease Trap Installation
❑ Septic Tank Installation
Cl Dosing Tank
❑ Drainfield showing signs of FAILURE!!
in outlet of tank
❑ Sod Installation
❑ Septic Hole Excavation
❑ Skid Loader
❑ Customer requested a Drainfield Estimate
❑ Potential plumbing problem
❑ Backhoe Services
❑ Mini -Excavator
❑ Permit Fee
❑ Outlet screen installed in deflection device
❑ PTI Multi -Pipe Installation
❑ Labor
❑ Contractor Fee
(] Excessive: ❑ Grease ❑ Waste
R IN TANK
❑ Other
❑
❑
� gRoots ❑ Sand
❑ IN LINES
0! UTILITY SERVICES
❑ Client requested a POMS agreement
❑ POMS Client
❑ Flat Rate Job - U
❑ Flat Rate Job - L
❑ Client requested a proposal for additional work
❑ Labor - U
❑ Labor - L
❑ ON -CALL After Hours Emergency Service I
❑ Labor - 2nd Tech - U
❑ Labor - 2nd Tech
Tech recohimends the following
-
❑ Utility Parts - U
❑ Lift Station Parts - L
❑ OSTDS Maintenance
❑ New Drainfield
❑ Other - U
❑ Lift Station Maintenance - I
❑ Need New Septic Lid Installed
❑ New Tank
❑ Subcontractor
❑ Other - L hours
❑ Installing Outlet Baffle
❑ Hydro Jetting
❑ Vactor Services - V
hours
❑ Intalling Outlet Filler Device
❑ Video Camera
❑
❑ •
❑ Biological Treatment
El Vactor (Vac -Con) Services
❑ POMS Upgrade
❑ Root Treatment
❑Flat Rate Job P
El Flat Rate Job - B
❑ "Priority -One" Maintenance
fl See Comments Below
❑ Additional Repairs
❑
❑ Labor - P
❑ Labor - 2nd Tech - P
El Labor - B
❑ Labor - 2nd Tech - B
❑ Plumbing Parts - P
❑ Rental Equipment - P
❑ Backflow Parts - B
WARRANTY From • ' Services Provided
❑ Does Not Apply/No Guarantee
❑ 90 Days
❑ Service Charge - P
❑ Initial Investment
❑ 24 Hours
❑ 1 Year
❑ Estimatefrroubleshoot Only - P ❑ Plumbing Inspection
❑ 30 Days
❑ 5 Year
❑ Video Camera - C - Inspection ❑ Video Tape/DVD
_ „ „ _ ,
_ • •
❑ Underground Location - u
❑ Leak Detection
y❑
Sewer Main - m
❑ Floor Drain - f
❑ Dishwasher
❑ Commode - a
❑ Kitchen Sink - k
❑ Tub
❑ Urinal
IIBIRSiok -
- -❑Shower
• �- " . ,.
❑ 2nd Line Cleaned - d
❑ 3rd Line Cleaned - d
❑ Laundry
❑ Whole Building Special - D
❑ Other
❑ Roof Drain
❑ Hydro Jetting Services - J
❑ Performed Treatment
❑ Storm Drain
n
Thank you for ahllrays calling III
"Commit to the Lord whatever you do, and your plans will succeed "
Proverbs 16:3
I authorize KIRK ENTERPRISES, INC. to perform the described
services and I agree to pay the amounts indicated above.
X
Client's Authorization Signature
Authorizing Agent's Printed Name
❑ Drain Maintainer - Gals
❑ 12 - Pack SIT Treatment
❑ Root Destroyer
❑ Floatinq Degreaser
gallons 1
12-paks 3
2-lb containers 5
5-gallons 7
$35.00 or 5% (whichever is greater) Service Charge for all Returned Checks
NET 10 DAYS from date on invoice. 1.5% late fee/month + legal collection
"A good name is more desirable than great riches". - Proverbs 22:1 a
I concur that the above referenced services . . • .
were perfomed to my complete satisfaction.
X
Client / Generator's Satlisfaction Signature
Transporter KIRK Service Techls}r - -�
0
0
Gn"N pumpwc s
P.O. BOX 13571
Fort Pierce, FL 34979-3571
800-330-7686
LEB DEMOLITION
ATTN: LEE BECKFORD
12805 S. INDIAN RIVER DR
JENSEN BEACH FL 34957
INVOICE
01/06/11 46131K
Note: Called in by LEE
Description Cost
1000 GALLONS TRK# 92 CLEANED SEPTIC TANK 215.00
" Commit to the Lord whatever you do,
and your plans will succeed " - Proverbs 16:3
SubTotal
Total
Received
Job Site LEE BEDFORD Balance Due
5715 CASSIA DR FP
r
p■ '' IaL R' g4RGC
�EM.
TERMS Payment Due Upon Service Date
BALANCES OVER 10 DAYS ARE SUBJECT OT A 1.5% CHARGE
Please detach and return with your payment
f KRK
LEB DEMOLITION
ATTN: LEE BECKFORD
12805 S. INDIAN RIVER DR
JENSEN BEACH FL 34957
215.00
0.00
215.00
PAYMENT DUE 01/16/11
Invoice #: 46131 K
Date: 01 /06/11
Balance Due: 215.00
Remitto: KRK Enterprises, Inc.
P.O. BOX 13571
Fort Pierce, FL 34979-3571
800-330-7686
Property Appraiser - St.Lucie Count) __
Page 1 of I
St Lucie County Record: 1 of 1
Property Identification
Site Address:
5715 Cassia Dr
Sec/Town/Range:
12 :36S :40E
Map ID.
34/12N
Zoning:
RS-4
Ownership and Mailing
Owner: St Lucie County
Address 437 N 7th St
Fort Pierce FL 34950
PROPERTY RECORD CARD
«Prey Next >> Spec.Assmnt Taxes Exemptions Permits Home Print
��CIE CO
ParcellD: 3402-610-0255-000-8 N Gy
Account #: 38394 I
ff
Land Use: SF Res
City/Cnty St Lucie County �'•
Legal Description
INDIAN RIVER ESTATES-UNIT-09- BLK 78 LOT 30 (MAP 34/12N) (OR
3229-994)
Sales Information
Assessment 2010 Final
Total Land and Building
Date
Price
Code
Deed
Book/Page
2010 Final
51300
Land Value 10400 Acres: 0.23
8/10/2010
57900
0112
SP
3229 / 0994
Assessed
51300
Building Value. 40900
5/12/2010
100
0112
CT
3200 / 2117
Ag.Credit
0
Finished Area: 1980 SgFt
2/17/2000
55000
01
DE
1287 / 2603
Exempt:
26300
12/17/1999
0
01
WD
1270 / 1494
Taxable
25000
12/3/1999
100
01
CT
1266 / 0633
Taxes
530.25
5/27/1993
70000
00
WD
0843 / 2191
2/2/1993
100
01
WD
0828 / 2279
11/14/1990
68000
00
WD
0716 / 0758
11/1/1987
64500
00
CV
0566 / 1017
4/1/1987
55000
00
CV
0541 / 0958
BUILDING INFORMATION
Exterior Features
View
RoofCover
SM - Sheet Metal
RoofStruct:
GA - Gable
ExtType
HD+ - HD+
YearBlt:
1982
Frame:
Grade:
D+ - D+
EffYrBlt:
1982
PrimeWall:
WS - Wood/Sheath
StoryHght.
0020 - 2 Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
2
Electric:
MX - MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
2
HeatType:
FHA - FrcdHotAir
AvgHUFI:
STD
1/2Bath:
0
HeatFuel:
ELEC - Electric
Prm.Flors:
CU - Carpet
%A/C:
100
%Heated:
100
%Sprinkled.
0
Special Features and Yard Items
Land Information
Type
YS Qty
Units Qual Cond
YrBlt
No Land Use
Type
3CFT -3CFT
S 1
1 AV AV
1982
1 0100-SF Res
215 -Front Ft
80 125
3CFT -3CFT
S 1
1 AV AV
1982
SDSF - SITE DEV S-F
Y 1
1 AV AV
2001
THIS INFORMATION
IS BELIEVED TO BE CORRECT AT
THIS TIME
BUT IT IS SUBJECT TO CHANGE AND IS
NOT WARRANTED.
http://www.paslc.org/prc.asp?prclid=340261002550008 1/5/201 1