HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
QZLLLJ r ,,
Building Permit Application
Planning and Development Services /
Building and Code Regulation Division Commercial Residentialy
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT.LOCATION: .
Address: ':1k Q 1
Property Tax ID #: — o d -ow ' Lot No.- &P
Site Plan Name: Block No. cr>'(
Project Name; t an
New Electrical Meter Second Electrical Meter (Affidavit required)
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 Pitch
Construction: 2. 00 S . Ft. of First Floor: t
Total S�. Ft �f �
Cost of Construction:$ P4.000' 00 Utilities: _Sewer _Septic Building Height:
Name_VAP-YNOl c. H1k1ce Kai'-� �I _ Name: IMiC1{ _ Nk'( l(.]n0k ^,
Address: S� O 1 ��OC Company: ryong &055 po''v r) klc
City: p(� -(C2 V 5tate�L Address:LI��w LOk15' C'�
Zip Code: aRgB2 Fax: City: State: -'Flu
Phone No. 2= '9(4 0 b l E- Zip Code: Fax:
Mail: n C4n vA0A (• c o &► Phone Noo� -� n
Fill in fee simple Title Holder on next page (if different E-Mail �� it i` � W S&alowt- Up,-n
from the Owner listed above) State or County License "i or 0kCk
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.
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: —NotApplicable
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.
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 conflicts with anV applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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, wails, 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 Ipndpr nr an attnrnpv hpfnrp rnmmpnrine wnr€c nr recording your Notice of Commencement.
1b"/Qr1'o'�
SigNature of Contractor - or- Owner Builder as applicable
STATE OF FLQ A
COUNTY OF A &45
Sworn to (or affirmed) and subscribed before ma of
Physical Presence or Online Notarization
this `a day of 20`by
nwrl Ivy �W CL
Name dY person making statement.
Personally Known OR Produced Identification
Type of Identificatioh Produced_] 1
(Signature of Notary Public -State of Florida)
LAU€�A CAMIPERO
Commission No. Oil Z {Seal)
allotary Public
State of Florida
SS
Comm#HHM225
Expires 7/7/2025
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 10/12/21
k-- U -k—L. E
R.
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
COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING SHEET
APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED
BELOW:
Roof System
Required Sections of
the Permit Application
Form
Attachments Required
See List Below
Low Slope Application
A, B, C
1,P,3,4,5,6,7
Prescriptive 8UR-RAS 150
A, B, C
2,4,5,6,7
Asphaltic Shingles
A, 9, D
144,5,8.7
Concrete or Clay Tile
A, B, D, I
1,2,3,4 5,5,7
Metal Roofs
A, B, D
1,2,3,45,6,7
Waod Shingles and
Shakes
A, B, D
1,2,4,5,8,7
Other
As Applicable
1,2,3,4,5,67 _J
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 1.6, or if applicable, RAS 1.27 or RAS 128
4•
Other Component of product Approval
5.
Municipal Permit Appiication
6.
Owners Notification for Roofing Considerations (Reroofing Only)
7.
Any Required Roof Testing/Calculation Documentation
Form RooflnfoFeb21 Rev Feb 18, 2021
ST. LUCIE WORKS
Section A (General Information)
Master Permit No.
Process No.
�Q_
�ahCL #
2
Contractors Name: V
` t i�K�
License
Job Addres
'
ROOF CATEGORY
❑ Low Slope
Q Mechanically Fastened Tile
❑ Mortar/Adhesive Set Tiles
Asphaltic Shingles
❑ Metal Panel/5hingles
[]Wood Shingles/Shakes
❑ Prescriptive BUR-RAS 150
ROOF ROOF TYPE-
0 New roof ❑ Repair
❑ Maintenance #
Reroofing ❑Recovering
. ROOF SYSTEM INFORMATION )
Low Slope Roof Area (SF) � Steep Sloped Roof Area (SF) Total (SF Cad. — LJ
Section B (Roof Pfan)
5ketch 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.
ST. LUCIE WORKS
Section D (Steep Slope Roof System)
Roof System Manufacturer: 1.7� mzJ cu � v
Notice of Acceptance Number:
a1
Minimum Design Wind Pressures, If Ap_ icable (From RA51Z7 or Calculations):
Bone 2n g one 2r:• v one 3e:- ( "Zone 3r:
Zone 1-14 Zone —
Deck Type: Pl wtrpz�l
Type Underlayment:
FZ f Slope:
f 2 Insulation: I tio)
Fire Barrier: 7 Aj It)
Ridge Ventlfabon7 Fastener Type & Spacatg: ` "� L Q�C ►^0.� t� l
C.. \{
Adhesive Type: 6 7pj
Type Cap Sheet:
Mean RoofHeight: I S �- Roof Covering: 31-Nir1cl1t
Type & Size Drip �(� �C1Ptlt ,l
Edge: -�
n 1j