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Home My WebLink Aboutbuilding permitPlanning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 (772) 462-I553 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 for your use and occupancy. You may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own use or occupancy. You may not build or improve said structures for the purposes of selling or leasing that building. 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 county or municipal licensing ordinances. Initial If you sell or lease a building you have built or improved within one year after construction is complete, then a presumption is created that it was built or improved for sale or lease, which is a vi tion of this exemption. Initial You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Your construction must comply with all applicable laws, ordinances, build' codes, and zoning regulations. Initial I understand that the building official and inspectors are not there to design or give advice on ho o meet the minimum code. Initial . -N�' 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 reason they do not possess a license, I may be responsible and li ffor their cost of the license. Initial " \. I understand that if any person that is unlicensed and uninsured gets injured on my construcF5\, they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and rel 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 ltv day of _�� of 20 . e Owner/Builder Signature STATE OF FLOR-1:'� t , y6- ✓ COUNTY OF „� (1 The foreg ' g i r omen as wedge before me this y of by ( who is personally known to me, or who has pro e e l as ilentification. kf � Y ��'(✓� Signat re of Notary Type or Print Narne of Notary (Seal) Title: Notary Public Commission Number SLUM Revised 0217120 ; ; -r say t t ,f. i I S skkkc-"6mfflos, E All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BEJ%CCEPTED Date: G -13 -z. o -2-C1 Permit Number - Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Address: 9 � Property Tax ID #: Site Plan Name: Project Name: } t ;, Y,�t4- _,D}0_0 �CV� Residential Y Lot Block No. Additional work to be performed under this permit -check all that apply: —Mechanical _Gas Tank — Gas Piping _Shutters—Windows/Doors — Electric — Plumbing — Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ Name C., Ity: C-1 Z_ State: Zip Code: Fax: Phone No.— E-Mail: N>,Y) from the Owner listed above) Generator V Roof 1-1112- Pitch - 4_ f Sq. Ft. of First Floor: Utilities., _Sewer —Septic Building Height: Name: Company: Address: City: State: Zip Code: Phone No- E-Mail State or County License SUPPLEMENTAL CQNSTRUCTTION LIEN I AW INFORMATION DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: 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 commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants 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 requested 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF �° 1Q�4-1 STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Pre or Online Notarization this � day of �n� 3 (2 q !�! , � 2020 by Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 2020 by Name of person making statement. Name of person making statement. \ / Personally Known OR Produced Identification )s. Personally Known OR Produced Identification Type of Identification Type of Identification Produ a Produced :;;Y►"... TINA E CHURCH (Signature of Notary P o fi -+'•. EXPIRES February 27, 2021 (Signature of Notary Public- State of Florida g rY ) Commission No. Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. I I 2 C 7 CY o CL 72: E z 0 rL 0 ol c 2 U. m U) W w LL r" 2 C C"q- HP , E *0141 11", 4� 1 MIAM DACE DEPART.,%MN,T OF RFG1J7-ATORY.A2NM LCONIOMIC RESOURCES (RER) BOARD A -*ND CODE AD1111NISTRATION'DIVISIO.N Atlas Roofing Corporation 2000 Riveredge ParkivaySuite 800 Atlanta, GA. 30329 NILVUl-DADS COUNTY PRODUCT C017ROL SECMO.N I I S05 SW 26 Street. Room 20S Miami, Florida 33175-24741 T (786)315-2590,F (786) 3 L5-2i99 wivNY-.miamidade.j1oWeconomv SCOPE: This NOA is being issued under the applicable rates and regulations governing the use of construction materials. Tile documentation submitted Its been reviewed and accepted by Miami -Dade County RER -Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AIIJ). This NOA shall not be valid after the expiration date stated below. The Nliami-Dade County Product Control Section (It,. Mi.i mi Dade County) and/or the AIU (in- areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. if this product or material fails to perform in the accepted manner, the manufacturer will incur the expense ofsuch testing and the z'U-17 may immediately revoke, modi�i, or suspend the use of such product or material within rheir jurisdiction. RER reserves the -right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable buildinc, code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the ER-21i Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Pinnacle Pristine, StormMaster' Shake and ProLare'Architectural Shingles LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and -following statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein. RENEWAL of this NOA shaill be considered after renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERAATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply Willi any section of this NOA shall be cause for termination and removal of NOA. -ADVERTISENUEN7: The NOA number preceded by the words -Miami-Dade County, Florida, and follov;ed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then, it shall be done in its entirety. LNSPECTION, * A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises 15-0720.02 and consists of7pages I through S. I The submitted documentation was revieive4 by Fredc�y Seiniito k0l NGAN,o.: 17-0706.07 Expiration Date: 08/05120 Approval Date: 11/15118 Paige, I of 8 RooFiNr- -AssENmBLyAPPR0VAL CategoIT: Roofing Sab-category: Asphalt Shingles Materials: Laminate Deck TNpe: Wood nAMM I This apProves Pinnacle" Pristine, StormMastert Shake and ProLam- Architectural Shingles manufactured bv Atlas Roofing Corp., as described in Section 2 of this Notice of Acceptance, and desianed to comply with the Florida Building Code, IEggh Velocity Hurricane Zone. 2. PRODUCT DESCRIPTION Product Dinieustous Test Product Description Speciii—cations Plnnacle'4 Pristine, 14" x 39 -Vs- TAS 110 A heavy -weight, fiberglass reinforced, Mamtjlacirwing location �I, 2. 3, 4 hzininated asphalt shingle. Pinnacle' Pristine, 14-x 42" TAS 110 A heavykveight. Fiberglass reinforced, Manqfacturing location 41, 2, 3, 4 lan-iinated asphalt shingle. Storm?Vlaster'4 Shake 14"x 39 31y, TAS 110 A heavy-,vei-hi, fibereliss reinforced, : Chit factoring location -k2 laminated asphalt shing je. StorrulMastell Shake 14" x 42- TAS 110 A heavy�veit ght, fiberglass reinforced, JI-fainifiacturing location 42 laminated asphalt shingle, ProLam- Architectural 14- % 39 3,V TAS I 10 A heavi,-.v-eight, fiberglass reinforced, Mantifacturing location 41. 3, 4 lan-tinated asphalt shingle. ProLam-Architectural 14" x 42" TAS 110 A heavyweight, fiberglass reinforced, Manufactiaing locaticn =1, 3, 4 laminated asphalt shingle. 2.1. $ �,NTuT�AcTLTLN�r-LoCATIO.N�S 1. Hampton, GA 2. Datigaerfield, TX 3. Meridian-N-TS 4. Franklin, OH NTOA -.Ko.: 17-0706,07 �,MDADE COUNTY C-01IMMOMIMIT, Expiration Date: 08/05120 Approval Date: 11115/1S page 1- 0.1 a 3. EV—IDLNCE SUMUTTED Test Agencti Test Identifier Test IN ame/Repoil Date PPJ COWMC6011 NfaterinIq Technologies ASTM D 2-462 ATL-OSS-02-01 0 6,,2 2," 11 TAS 107 ATL-054-02-01 05041l0 TAS 100 ATL-053-02-01 05f0411O TAS 100 ATL-1 19-02-01 07/22" 13 TAS 107 ATI-133-02-01 09,;26!13 ASTNI D 3462 &TL- 136-02-01 10/141,113 TAS 100 -A71L-107-02-01 12;12f'13 TAS 107 -A.TL-143-02-01 11101/13 ASTM D 3462 A=-1 IS-0-2-0 1 06/26,113 TAS 107 ATL-106-02-01 09105114 ASTM D 3462 A-EL-IG4,-02-01 04/211I3 ASTIM D 3462 ATL-135-02-01 10114113 ASTM D 3462 -ATL-I 16-02-01 06/26113 TAS 107 ATIL-132-02-01 09/26,113 TAS 100 -,kTL-125-02-01 07122113 TAS 107 ATIL-144-02-01 i 1/01113 ASTM D 3462 -ATL-220-02-01 1 W 12Y 17 TAS 100 ATL220-02-02.1 10/12117 TAS 107 ATL-220-02-03 10/12/17 ASTIM D 3462 ATI L-221-02-01 10112117 TAS 100 kTL-221-02-02.1 I Of 12 f 1 -1 TAS 107 ATL-211 1 -02-03 10`1 2-i'l 7 ASTM D 3462 -ATL-222-02-01 1 W 1'117 TAS 100 ATIL-2,22-02-02 10/12/1' , 7 TAS 107 ATIL-222-02-03 10,11,1117 AST D 3462 ATL-223-02-01 10112 17 TAS 100 ATL-223-02-02,1 10/12/17 TAS 107 -A-TL-223-02-03 I W12117 ASTIM D 3462 -ATL-224-02-01 1011 2) /17 Underwriters I-qboruories, Inc. UL 790 1 ICA51478 02/01/12 NOAN-o.. 1-7-0706.07 MIAMIaDE CCkR47Y Expiration Date: 081"P-0 Approval Date: 11115118 Page 3 of 8 I. Fire classification is not part of this acceptance; refer to a current Approved Roofing N-laterials Directory for fire ratings of this product, 2. Shall not be installed on roof mean heights in excess of 33 ft. 3. All products listed herein shall have a quality assurance audit in accordance with The Florida Buildings, Code and Rule 61 G20-3 of the Florida Administrative Code. 5. INisTALLkTioN I. Shingles shall be installed in compliance with Roofing Application Standard ILLS 115. 2. Flashing shall be in accordance writh Roofing Application Standard RAS 115 3. The manufacturer shiL€ provide clearly written application instrucdolis. 4. Exposure and course layout shall be in compliance with Detail W. attached. S. 42-inch PimiacleTM Pristine 6-inch offset layout shall be in compliance with Detail 'B'. attached. & 42-inch ProLanfr'" Architectural 6-inch offset Invout shall be in compliance with Detail 'C', attached. 7. Pinnacle PristiaeT`11 Laminate sealant pattern shall be in compliance with Detail *D'. attached. S. ProLam 42 Laminate sealant pattern shall be iri compliance with Detail 'E*, attached. 9. Nailing shall be in compliance with Detail T'and Detail 'G'. attached. NOW Shingles shall be permanently labeled with the manufacturer's name and/or logo, city and state of inanufflacairing facility, and the folio -wing statement: -'Mianii-Dade County Product Control Approved- or with the Miami -Dade County Product Control Seal as seen below: 7. BLTILDRI'GPER-,NiiTREQrjiRENiEN-Ts Application for a building permit shall be accompanied by copies of the following: I. This Notice of -A:C-ceptance. 2. Any other documents required by the Building Official or the applicable code in order to properly evaluate the installation of this system, NOANo- 17-0706.07 kWMADECOUNTY Expiration Date.* 08105,120 COMM= ApprovilDate. 11/15/18 Page 4 of FULL SM FOURTH I TRIM 14"—/ i THIRD COU� PIMNUCLO PRISTINE, STORMAIASTEO AND PROLAl-' CHITECT Tfum 5- -z' FULL SHINGLE 8cCOM13 COURSE HIAM14=f COUNTY NO A No.: 17-0706.07 Tf :13 Expiratiou Date: 08105M Approval Date. 1111 i/I 8 Page 5 of 8 DETAILS' Zero Waste', 6" Off Set 42 11 PINNACLE PRISTINEThl 6" OFFSET DET.im ICI zpro Wast" 6' Offset Cut From Course 2 l!,c.trm=c0—a3 Is" Cut from CQUm* 4 1-4 "Cutshi=ee o" Cut sltirja 6" C— Rell 4", Ull 41.11 4211 PRoL.A.NmTal -ARcEaTEcTLTAL 6,1 OFFSET NOA.No.: 17-0706.07 Expiration Date: 08/05P20 Approval Date: 11115119 Page 6 of 8 DET-kn,'DI aOTTt.� 01� Cf� 'i �C,4`71 El, �,, mm movL-unw. aw- "aim - VFM'-OW mr -am -M PINNACLE'r-"' PRISUM 42" L-AMENATF SEALANT PATTFRN 4 PRoLAm ARCMIECTUIR_kl��l 42 11 LA.,mINATE SEALANT P_,k=R_N - No.: 17-0706.07 ®R ;N'OA Expiration Date: 08/05110 Approval Date: 11115118 Page 7 of 39 APPROVED rASTENER 7 zvf� CD ED C=;, C:I ct) DET.UL'G' 14' 4T ffmfla�� - NOA No,: 17-0706.07 Expiration Date: 081050-0 Approval Date: 11115118 Page 8 Ora