HomeMy WebLinkAboutRobert Grande Permit Application.pdf1c.' LL I-CILL
ST. LUCIE
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
COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING SHEET
APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED
Roof System
Required Sections of
the Permit Application
Form
Attachments Required
See List Below
Low Slope Application
A, B, C
1,2,3,4,5,6,7
Prescriptive BUR-RAS 150
A, B, C
2,4,5,6,7
Asphaltic Shingles
A, B, D
1,2,4,5,6,7
Concrete or Clay Tile
A, B, D, E
1,2,3,4,5,6,7
Metal Roofs
A, B, D
1,43,4,5,6,7"
Wood Shingles and
Shakes
A, B, D
1,2,4,6,6,7
Other
As Applicable
1,2,3,4,5,6,7
ATTACHMENTS REQUIRED As Applicable):
1.
Fire Directory Listing Page
2.
From Product Approval:
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
S.
Municipal Permit Application
6.
Owners Notification for Roofing Considerations (Reroofing Only)
7.
Any Required Roof Testing/Calculation Documentation
Form RooflnfoFeb21 Rev Feb 18, 2021
s 6 Sk ludIL Co
All APPLICABLE NFO ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Ub 01 Permit Number:
`-r LLCCL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: _Pope--'- J. &m—tile,
PROPOSED IMPROVEMENT LOCATION: tt
Address: 1'2,Dk VJWk-e G11J(— l.Vl. tEl �k(w/7�C/kt li �3 'cl'8%
PropertyTaxlD#: Z?� yi oyl,5 Cyo2 Lot No. ((P
Site Plan Name: f Block No.
Project Name: 6 p '�ei SIc%&VIC,-C.
I DETAILED DESCRIPTION OF WORK: I
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator Roof ✓� Z' Pitch
Total Sq. Ft of Construction: �yq_as�5 Sq. Ft. of First Floor:
Cost of Construction: $ �li�i (� , �"C.o Utilities: _Sewer _Septic Building Height: L
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Address: 112,01 IA - D0. % L ky.
Company: 0 kay-e—
City: Rr'Yz-C._" State:JE:�
Zip Code: 59-g9*2 Fax:
Phone No. '17?— ?�2 (155'74
Address: D
City: Qa"L F( Stater
Zip Code:':3LM'? Fax: �—
Phone No
E-Mail: 4
Fill in fee situp a Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
.x.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: te:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDS • Not Applicable
BONDING COMP AN 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 attornev before commencing work or recording vour Notice of Commencement.
no
Signature of ner/ -ssee/Contractor as Agent for Owner
Signature =t�License Holder
STATE OF F D r n '_
COUNTY OF A1V. Y1
STATE ODA
COUNTY OF (,N1
Svern to (or affirmed) and subscribed before me of
S�rn to (or affirmed) and subscribed before me of
h sical Prese ce or Online Notarization
ISO- u
sical Pre nce or Online Notarization
W
this day of , 2021 by
Lsk.o
this day of 202 j by
kohod s�
Name of per on making statement.
Name of pe son making statement.
Personally Known OR Produced Identification
Personally Known on
Type of Identificatio
Type of Ide i tc b?n S W. STEVENS
Produced
Produced •ti• �
*pYp MAS W. STEVENS
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(Signat re-'. f ' ff ��pridal�}'r
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(Signature of Notary ic- State of Florida )
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Commis o. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 576720