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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S-u -Ca-\ Permit Number:
W. p _ RECEIVED
Building Permit Application
MQY 2 0_1011
Planning and Development Services
Building and Code Regulation Division Permittin Department
2300 Virginia Avenue,Fort Pierce FL 34982 St L ie Countv
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
Esis '� •L .y'�`" s
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Address: 'z
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/ oors
Electric _Plumbiin_g /� _Sprinklers _Generator X Roof �. Pitch
Total Sq. Ft of Construction: �(��y Sq.,Ft. of First Floor:
Cost of Construction: $ / Z-1 500 Utilities: —Sewer —Septic Building Height:
MM
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.� - y `7' M :,.w� r.,. EE i t i^� -"a,.§c. •�-ate' $s.
R ._ '! c:_" F .� Via' --err i ¢^�` ...yr ;.
Name 4 Name:
Address: 2 r Company:
City: k-o'ck QIE.1 ," State: Address:
Zip Code: 2D Fax: City: State:
Phone No. ��-A 4 Q 2 . (0 O Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
� N
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 YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE F!RST INSPECTION_ IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH LENDER OR AN ATTORIkY BEFORE RECORDiI lv YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ ssee/Co t actor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA t STATE OF FLORIDA
COUNTY OF o�iY• Ill C,Lt , COUNTY OF
The forgoing instr nt was acknowled d before me The forgoing instrument was acknowledged before me
this ay of �� 2 � by this day of 20_ by
Name of person makind statement. Name of person making statement.
Personally Known OR Produced Identification 1/ Personally Known OR Produced Identification
Type of Identific Type of Identification
Produced Produced
.I
jA
(Signature of N tary Public-State of Florida) (Signature of Notary Public-State of Florida )
Commission No. AREN . NIELSEN Commission No. (Seal)
tear aye
State of Florida-Notary Public
=r r=
0,F,Qom My Commission Ex fires
REVIEWS dNF' ZONINC.12, ��ERVI R PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. /19
olyo 1=019
O Planning&Development Services Department
• _• Building&Code Regulations
- - 2300 Virginia Avenue RECEIVED
Fort Pierce,Florida 34982
(772)462-1553 M0 2 01021
OWNERBUILDER AFFIDAVIT DISCLOSURE STATEMENT Permitting Department
F.S.489.103(7)EXEMPTIONS St. Lucie County
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 by county
or municipal licensing ordinances.
Initi He e
If you sell or lease a building you have built or improved within one year after construction omp ete, then a
presumption is created that it was built or improved for sale or lease,which is a violation of this exemption.
Init' erg^^
You may not delegate the responsibility for supervising work to a licensed contractor who is n licensed to perform
the work being done. Your construction must comply with all applicable laws, ordinances, b ' ding codes, and
zoning regulations. In' al er .
LAI
I understand that the buildingofficial and inspectors are not there to design or give advi ow meet the
P
minimum code. In' ial He e
I understand that as an owner-builder that any contract disputes with sub-contractors and I must a handl d in a civil
court with the advice of an attorney. This department will not mitigate any contract disputes.
In' is re.
I understand that if I compensate any person or company for work performed they are require to be I c nsed in this
jurisdiction. If for some reason they do not possess a license, I may be responsible and liable^^the cost of the
license. pptriojectfihey
re.
I understand that if an person that is unlicensed and uninsured gets injured on m constructia be
YP g J Y Y
entitled to workmen's compensation. I could be held liable for all doctor, lawyer and related ritedir*l cost, which
could include loss of wages during recovery from their injury. 1 tial re.
To qualify for this exemption under this subsection, an owner must personally appear, sign a bui ng 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 ed by the Building andl Zoning
Department to the Florida Stat Department of Professional Regulation. tgned ac owledged on s o�()
day of of 2(9�,�.
kn�e_r/BuiVder Signa e
STATE OF FLO A
COUNTY OF
The foregoing ins ent w acknowledged before me this o day of ,20& ,
by e who is personally known to me,or who has
produced as identification.
90�AAA t�l
Signature of Notary Type or Print Name of Notary (Seal)
Title:Notary Public
tiPpY pV� KAREN S. NIELSEN
;State of Florida-Notary Public
Commission # GG 207484
°P MyC:nimission Expires
June 12, 2022
a ST. LUCIE WORKS
ST LUCIE COUNTY ROOFING PERMIT INFORMATION SHEET
Florida Building Code 7th Edition (2020)
Based on Section 1525 of the Florida Building Code-Building
INSTRUCTION PAGE y
COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING SHEET
APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED
BELOW:
Required Sections of Attachments Required
Roof System the Permit Application See List Below
Form
Low Slope Application A, B,C 1234,56
Prescriptive BUR-RAS 150 A, B,C 2,4,5,6,7
Asphaltic Shingles A, B, D t'x¢;�gy
Concrete or Clay Tile A, B, D, E 1;m456T_
Metal Roofs A,B, D 1, 4A T
Wood Shingles and A, B, D t�P;4S 7
Shakes
Other As Applicable T.Z_4A6,7
ATTACHMENTS REQUIRED As Applicable):
1. Fire Directory Listing Page
2. From Product Approval:
1 Front Page
Specific System Description
Specific System Limitations
General Limitations
Applicable Detail Drawings
3. Design Calculations per Chapter 16,or if applicable, RAS 127 or RAS 128
4. Other Component of Product Approval
5. Municipal Permit Application
6. Owners Notification for Roofing Considerations(Reroofing Only)
7. Any Required Roof Testing/Calculation Documentation
Form RooflnfoFeb21 Rev Feb 18,2021
f �
ST. LUCIE WORKS
Section A(General Information)
Master Permit No. Process No.
Contractors Name: License#
Job Addres
ROOF CATEGORY
O Low Slope 0 Mechanically Fastened Tile 0 Mortar/Adhesive Set Tiles
11 sphaltic Shingles 13 Metal Panel/Shingles QWood Shingles/Shakes
El Prescriptive BUR-RAS 150
ROOF ROOF TYPE-
El New roof 0 Repair 0 Maintenance Reroofing D Recovering
-ROOF SYSTEM INFORMATION
Low Slope Roof Area (SF) W Steep Sloped Roof Area(SF) Total(SF)-C �V
Section B(Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains.
Include dimensions of sections and levels,clearly identify dimensions of elevated pressure zones and location of parapets.
r r .
ST. LUCIE WORKS
Section C(Low Slope Roof) surfacing:
Fill in specific roof a embly components and identify Fastener Spacing for Anchor/Base Sheet Attachment:
manufacturer Zone 1':—" oc @ Lap,#Rows `.
(If a component is not sed,identify as"NA") Zone 1:—" oc @Lap,#Rows
System Manufacturer: Zone 2:—" oc @ Lap,#Rows
Zone 3:—" oc @ Lap,#Rows—
Product Approval No.:
Number of Fasteners Per Insulation Board:
Design Wind Pressures,From \2: Zone
alculations: Zone 1': Zone 1: Zone 2: Zone 3:
Zone 1':—Zone 1: Zon 3: Illustrate Compon is Noted and Details as Applicable:
Max. Design Pressure,from toduct approval Woodblockin Gutter, Edge Termination, Stripping,
system: Flashing, ntinuous Cleat, Cant Strip, Base Flashing,
Counter ashing,Coping,Etc.,
Deck: Indic e: Mean Roof Height, Parapet Height, Height of Base
Type: FI shing,Component Material,Material'Thickness, Fastener
ype,Fastener Spacing or Submit Manufacturers Details that
Gauge Thickness: Comply with RAS 111 and Chapter 16..
Slope:
Anchor/Base Sheet&No.df Ply(s):
Anchor/Base Sheet Fastener/Bonding Material
FT.
Insulation Base Layer:
Base Insultation Size and Thickness: Pafapet
Base Insulation Fastener/Bonding terial: Helght
Top Insulation Layer:
Top Insulation ZFasten /Bonding
ess: FT.
Top Insulation Material:
Mean
Base Sheet(s)&No.of Ply(s): Roof
Base Sheet Fastener/Bonding Material: Height
Ply Sheet(s)'&No.of Ply(s):
Ply Sheet Fastener/Bonding Material:
Top Ply:
Top Ply Fastener/Bonding Material:
ST. LUCIE-WORKS
Section D (Steep Slope Roof�Sy�t M
Roof System Manufacturer: —
Notice of Acceptance Number:
Minimum Design Wind Pressures, If Applicable(From RAS 127 or Calculations):
Zone 1: Zone 2e: Zone 2n: Zone 2r: Zone 3e: Zone 3r:
Deck TY06.
000
Type.Underiajrrients C
12 insufatio .
Tice Barrier: •
Ridge Ventgahon? t=astener Type&Spacing;
lkd ql*Type:
TYRe Caa•Sheet
Mean RodfHeight: _ Roof'Covering.
Type CY Drip
e
ST. LUCIE WORKS
Section E(Tile Calculations)
For Moment based tile systems,choose either Method 1 or 2.Compare the values for Mr with the values from Mr.If the Mf values.
are greater than or equal to the Mrvalues,for each area of the roof,then the tile attachment method is acceptable.
Method 1'Moment Based Tile Calculations Per RAS 12T
(on e 1: X1� Product Approval M,
=-a4f
( ne 2e: X1.. a _ .= _; Product Approval Mf
(Zo e2n: Product Approval Mf
(Zone r: xk: _ _�-Mg3 °M,� Product Approval Mf
(Zone 3e: X�L -� � Product Approval Mf
(Zone 3r: X -J Yw- =' Product Approval Mf
Method 2"Simplified Tile Calculations Per Table Below"
Required Moment of Resistance(Mr rom Table Below Product Approval Mf
required moment Resistance*
Mean Roof Height Roof Slope 15, 20' 25' 30' 40'
2:12 34.4 36.5 38.2 39.7 1142.2
3:12 32.2 34.4 36.0 37.4 39.8
4:12 30.4 .2 33.8 35. 37.3
5:12 28.4 30. 31.6 3 Kz.8 34.9
6:12 26.4 28.0 29.4 30.5 32.4
7:12 1 24.4 25.9 27.1 28.2 30.0
*Must be used in conjunction w/en
moment based 'le systems
• For Uplift based tile systems us3.Compare the v ues r F'with the values for Fr If the F'values are greater than or
equal to the Fr values,for each roof,then the the achment method is acceptable.
d 3"Uplift Bas Tile a``lculations Per RAS 12T
(Zone 1: x L =x W: : c r =F� Product Approval F'
(Zone 2e: x L =x W: W: cos r =Frze. ProductApproval F'
t(Zone 2n: x L =x WW: cos r =Frz" : Product Approval F'
(Zone 2r: x L =x W: cos r =Frzr Product Approval F'
(Zone 3e: x L =x WW: cos r =Fr3e °\Product Approval F'
(Zone 3r: x L =x W: W: cos r =Fr3r Product Approval F'
Where to Obtain Information
Description Symbol Where to find
Design Pressure Zones 1,2e,2n,2r,3e,3r From applicable table in RAS 127 or by an engineering analysis
/- prepared by PE based on ASCE 7
Mean Roof Height H Job Site
Roof Slope 6 Job Site
Aerodynamic Multiplier a Product Approval
Restoring Moment due to Gravity Mg Product Approval
Attachment Resistance Mf Product Approval
Required Moment Resistance Mg Calculated
Minimum Attachment Resistance F' Product Approval
Required Uplift Resistance Fr Calculated
Average Tile Weight W Product Approval
Tile Dimensions L=length W=width Product Approval
All calculations must be submitted to the building official at the time of permit application.