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Residential Roof Dry - In Affidavit
St Lucie County, Public Works Department
Code Compliance Division
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Building Permit # 0'1 I'd ~ L 2L(p F·:' I tC C: . OP",.·t/
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Owner'sNam:d~/7r:' /¿~~~ . .
Owner'sAddress goo~- ¿d-þQ.d;7 /Ýv~ //-A~c~ ~/
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Contractor
Contractor's Address
I certify that: The required Lapping and Fasteners of the underlayment
(roof felt); hot mop, if required and flashing have been installed in
accordance with Chapter 15 of the Florida Building Code and Chapter 9
of the Florida Building Code, Residential with approved revisions and
. meet the requirements of the product approval.
I understand that by executing this Affidavit I hereby relieve St Lucie
County of any liability with respect to the installation of these materials.
STATE OF FLORIDh: ' I
COUNTY OF 2>4 ·l.J..;1U)
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The foregoing i~!.{Ument was ac~owledged
r,b.,efore me this -.f:fday of ltOLCC 2c([) by
tJ}Ovt.t KI ~ Ct..,Ä./, ~ho is personally
known to ~ or w 0 has pro¡Ò\J.ced
\<.Q4 .. l 10 !J.) tag identification.
NO'f:~, ,. _. ì r~'T'4,~~ OF FLOR.lDA~
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Type or t Name of Notarf ~k.-,,~" " .:. .~ - . , :'1 .) .L) 8 9 b~ 0/ 4
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ommission o. ¡;ÞlDFn'·;hj· , .,-(ߪ~u\G CO., INC.
STATE OF FLORID~.
COUNTY OF ~~ " WLL~
The foregoing instrument was acknowledged
before me this 'Z..,"lday of U1)...-L{ , 2iil, by
D , ~ ~'1{' ~ ( ~~ Illl, who is personally
~Ç..wn to me or who has produced
I'-~~~" 1,0 ·17 · (jJdb~identification.
Commission No.
No Faxed Copies, Only Original Notarized Copy will be accepted.
Cml revised 1 I] 7/2007
DATE: SOd?' ðf
PERMIT NUMBER· (:) 4 (d 4. l:> t lp
ATTENTION: RA Y W AZNY, BUILDING OFFICIAL
I , (OWNER/BUILDER),
AM REQUESTING THAT TH ABO PERMIT NUMBER BE RENEWED. I
UNDERSTAND THAT I MUST SCHEDULE AND PASS ALL NEEDED
INSPECTIONS FOR THIS PERMIT TO BE FINALED.
OWNER'S A
ADDRESS 9QJ-=:;- ~~7 4lk-. /;? /è:?~~ ~/ ?Y5!S /
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OWNER'S PHONE-NUMBER 77/ 'S3:? -27>c:õ'Cl
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Code Compliance Division
2300 Virginia Avenue
Ft. Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1148
http://stlucieco.gov/ce
BUILDING PERMIT
Page
Issued: 01/13/2005
Job Location: 8005 BELMONT AVE
Permit Type: Roof
Job Description: fiberglass shingle 24 sf 5/12 pitch
Subdiv: Lakewood Park Unit 4
Lot: 30 Block: 31
Cont #: 0352
Permit#: SLC- 0412-1216
City: FORT PIERCE
Parcel: 1301-604-0123-1 00/0
Contractor
SCHUMACHER KURT
6411 ARC WAY
ANCHOR ROOFING OF SOUTHWEST (239) 573-7663
FT MYERS, FL 33912
Property Owner
Diane Kingsley
8005 Belmont Ave
( ) -
Fort Pierce, FL 34951
Setbacks Left:
Number ot Units: 1.00
Minimum Floor Elevation:
Right:
Floors:
Front: Rear: Zoning: RS-4
Buildings: Square Footage: 0.00
Flood Map: Flood Zone: Elev:
Job Value: $ 12,158.00
Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code
including those for all electric, plumbing, mechanical, roofing, and structural work. Further, he/she acknowledges responsibility to comply with all
requirements of the 2004 Florida Building Code.
NOTICE: In addition to the requirements in this permit, there may be additional restrictions applicable to this property that may be found in the
records of this County, and there may be additional permits required from other governmental entities such as water management districts, state
agencies, or federal agencies. s:553. 79(10), F.S.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
BUILDING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. s.713.135, F.S.
Christopher Lestrange
Building Official
Date
For Automated Inspections, Call (772) 462-1261
For Questions, Call (772) 462-2172
St. Lucie County Land Development Code Section 11.05.01 (A) (2) states; Building Permits shall expire and
become null and void if work authorized by such Building Permit is not commenced, having called for and
received a satisfactory inspection, within six (6) months from the date of issuance of the permit, or if the work
is not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of
issuance of the Building Permit.