HomeMy WebLinkAboutApplication for Roof PermitDATE: _ ( FEES DUE: J • 80 RECEIPT #: Permit #:
1. Location/Site Address:
2. Parcel ID Number:
St. Lucie County Building & Zoning
t 2300 Virginia Avenue Ft. Pierce, FL 34982-5652
Tel. 772-462-1553
APPLICATION FOR ROOF PERMIT
/Q '_� CGrS1E�EASESIDE ORINSTRUCTIDNS
Office Use
Only
Section
Township
Range
1 Map Page
I Zoning
Land Use
1 Initials
1 2�
OJ
3. Description of Project or Work Activity: b KErooP
4. Total Roof Area (square feet): ?w 5. Roof Pitch:
6. Type of Roof:
7.
W Fiberglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle
[ ] Tar & Gravel [ ] Modified Bitumen [ ] Other
mA N.O.A. or Florida — Product Approval required for all types of Roofing Material (2 Sets)
[ ] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product
Approval attached
** Roof Mitigation per F.S. 553.844 will be required.
Owner Information 18. Contractor Information
Name:O
Address: 4 54 * Cah 14 FL
City: Pr �� Y r �e_ State: —,
Zip: Y Phone: !)I z 5 3 2,
9. Value of Construction: $ � % 0 Im
Note Dry -in and Final Inspection Required
Additional inspection may be required per Product Approval
FL Reg/Cert #: CCG 053 0Z f
County Cert #: 205 0 to
Business Name:.�I
Fees Due: i -:36 ' Do
Receipt #:
CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is correct and that all work will be
done in compliance with all applicable laws regulating construction and zoning.
RINT QUALIFIERS/OWNERS NAME ,,,:J I"' G�TURE OF QUALIFIERIOWNER
STATE OF FLORIDA, COUNTY OF 2,erg,
ACKNOWLEDGED BEFORE ME THIS _ DAY OF 20 0 ` • BY bha�&
ILSp TO ME OR HAS PRODUCED AS IDENTIFICATION
V'o�g , LORIE A. GERSTEMSER
NA MBYondCeOd TMnIrCu NotaAry N # DD 51#317
F OTARY TYPEORPRINTNAMOOTARY 'Id201
EXPIRES:FebNaFebruary 0
Puhlic Undanriters COMMISSION ER
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR 11UPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.