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Home My WebLink About0503-0349 APPLICATION FOR ROOF PERMITMASTER PERMIT: PERMIT n uMBER: 1. 2. 3. LOCATION/SITE ADDRESS: PARCEL ID NUMBER: ST. LUCIE COUNTY PUBLIC WORKS BUILDING & ZONING DEPARTMENT FORT PIERCENIA AVENUE FL 349 2- 652 �8 r 561-462-1553 APPLICATION FOR ROOF PERMIT SEE REVERSE SIDE FOR INSTRUCTIONS IL'1Z'S'J/.11I1�1�1•i SECT I /1-t I TWP [1(l,") I RNG I WJt/ I MAP DESCRIPTION OF PROJECT OR WORK ACTIVITY: DATE: 13 1-06 ZNG I I LU I I INIT - U U 4. TOTAL ROOF AREA (Square Feet): Iy Fd-D 5. ROOF PITCH: 6. TYPE OF ROOF: FIBERGLASS SHINGLE [ ] WOOD SHAKE/SHINGLE [ ] (check one) BARREL TILE/CERAMIC [ ] TAR & GRAVEL [ ] OTHER (SPECIFY): [•]' /l7h�''i�urn��✓ 7. OWNERS _ INFORMATION ? I ,�,, 8. CONTRACTORS INFORMATION Name: J�'G[� , UGC' LGf, (�J ,�KU f d,�IC ' FL REG/CERT #:� Address: COUNTY CERT #: City: 1A : �L'�%jjlJQi State: • ao-OL, Business Name: { f Phone: Zip: 9. VALUE OF CONSTRUCTION: $ -/D0-2, 6-D FEES DUE: RECEIPT: 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. i�C i"111AA t�A?4 PRINT QUALIFI -RS/OWNERS NAME NATY E OF A OWNS NCI 1 1111111/// •c�pFtET L. M�ti STATE OF FLORIDA, COUNTY OF � ...� ti .��P,•��,�SSIONF •, C',y �� SWORN TO AND SUBSCRIBED BEFORE ME TyIS DAY OF , 2005, WINO I,�, OFj4' j<NSVN TO ME OR WHO HAS PRODUCED ✓l�ff AS IDENTIFICATION. ? l � % L /li�/i�('� o #DD08//9515 ; o-- SIGNA RE OF NOTARY TYPE OR PRINT NAME OF NOTARY =• �• oid4pondeSpap� pQ\ NO ARY PUBLIC TITLE �� 5 I S COMMISSION NUMBER '�i o' , u6licunde: Q� UBl/CSTAZE��\ NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE�/N&hli VEMENTS TO YOUR PROPERTY.- IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ST. LUCIE COUNTY — ROOF PERMIT INSTRUCTIONS Please complete all information in the space provided. All information must be Printed (use black,br blue ink only) or Typed. This application for Roof Permit is to be used for only those activities involving the repair or replacement of the roof surface. This application for Roof Permit may not be used for any activity that includes any type or kind of alteration to the roof structure itself. Building activities involving structural alteration to the roof must be permitted through the regular building permit review process. The information to be provided with this application includes: 1. LOCATION/SITE ADDRESS: ............................................... Indicate the street address, or general location, of the property on which the building, activity is taking place. 2. PARCEL ID NUMBER: ........................................................ Indicate the Property Tax Identification Number for the property on which the building activity is taking place. 3. DESCRIPTION OF PROJECT OR WORK ACTIVITY........ Briefly describe the building activity under permit application 4. TOTAL ROOF AREA: .......................................................... Indicate the total square footage of the roof area to be affected by this building permit. 5. ROOF PITCH: ....................................................................... Indicate the pitch of the roof to be affected by this building permit. Pitch •is to be expressed as a standard ratio of run:rise. 6. TYPE OF ROOF: ................................................................. Indicate the type of roof which is being repaired or resurfaced. 7. OWNERS INFORMATION: ................................................. Indicate the name and address of the owner of the property on which the roof repair or replacement is taking place 8. CONTRACTORS INFORMATION: ............................... ...... Indicate the State of Florida (if applicable) and St. Lucie County contractors registration numbers, and the name of the business doing the repair or resurfacing work 9. VALUE OF CONSTRUCTION: ..................................... I.... Indicate the total value of the repair or resurfacing activity to take place. Total cost of construction includes all material and labor costs associated with the repair or resurfacing activity. The value of construction is used to determine the amount of permitting fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction. All applications for Roof Permits are to be submitted to the St. Lucie County Building and Zoning Department, Administration Building, 2300 Virginia Avenue, Fort Pierce, FL 34982. All applications for Roof Permits must be complete and filed with the Department no later than 4:30 P.M. each business day. No applications will be accepted for processing after 4:30 P.M. For assistance in completing this application, please contact the St. Lucie County Building & Zoning Department, at (561) 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. Following the issuance of this Roof Permit, the scheduling of all required inspections may be made by calling (561) 462-1261. SLCCDV FORM NO.: 008-05 SLCCDV Form No.: 001-02 OWNER INFORMATION: NAME: Atlantic View Beach Club ADDRESS: 5047 N AIA CITY: North Hutchinson Is. STATE: _FL ZIP 34949 PHONE (DAYTIME): IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE FILL IN NAME AND ADDRESS BELOW. FEE SIMPLE TITLEHOLDER: N/A ADDRESS: CITY: PHONE (DAYTIME): _(_) CONTRACTOR INFORMATION STATE: ZIP STATE Of FL REG./CERT #: CG - CA17617 ST. LI CIE COUNTY CERT #: 18745 BUSINESSNAME: Tomac of Florida. Inc. QUALIFIERS NAME: Terry S. McMillan ADDRESS: 3503 Ocean Drive CITY: Vero Beach STATE: FL zip 32963 PHONE (DAYTIME): _(772) 234-5661 FAX: (772) 234-5662 . ARCHIT/ENGINEER: Jenkins & Charland ADDRESS: 2011 S. 25th Street Suite211 CITY: Fort Pierce STATE: FL zip 34947 PHONE (DAYTIME): _(772) 466-3773 BONDING COMPANY: ADDRESS: CITY: MORTGAGE LENDER: ADDRESS: CITY: STATE: ZIP STATE: ZIP IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification it will be voided„ and returned to you by mail. CERTIFICATION: This application is hereby made to obtain a permit to do the work'and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND AIR CONDITIONERS, ETC., not otherwise included with this building permit application. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non- residential use. NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: AS THE APPLICANT FOR THIS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT; AS A CONDITION OF THIS PERMIT YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE ATTACHED CONSTRUCTIONILIEN LAW NOTICE TO -THE PERSON WHOSE -PROPERTY IS SUBJECT TO ATTACHMENT. OWZFIDAV -Icertify at all the'foregoing information is accurate a k will be done in compliance ith al licable laws regulating construction zoning.OWNGNATURE CONT IGN RE STATE OF FLORIDA STATE OF FLORIDA COUNTY OF �bi ta��i w / COUNTY OF 110 A�`��y�'�c• The foregoing instrument wgs acknowledged before me this k&day of , 200_y'S-by Mc tom. !t,,y who is personally✓ known to me or who has produced Signature of Notary Type or Print Name of Notary Commission Nv (Seal) PATRICIA A. MURRAY MY COMMISSION N DD 280669 EXPIRES; May 10, 2008 Bonded Thru Notary Public Underwdlers The foregoing instrument w acknowledged before me this «day of , 20 Z who is personally known to me or who has produced Signature of Notary Type or Print Name of Notary Commission Nola i�ro Q (Seal) NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THE APPLICATION. For specific instructions see appropriate permit checklist. OFFICE USE ONLY BP #:. SECTION TOWNSHIP RANGE MAP NO. ZONING LAND USE CVG % TAZ NO. FLOOD ZONE FIRM P ls'r FLR ELV MAX HGT CONST TYPE OCCU E MAX OCCUP # OF FLRS WATER SEWER SPRINKLERS STORMWATER LOT OF REC (before 1/90 - LOT OF REC (after 1/90) LOT SPLIT REQUIRED LOT SPLIT APPROVED ADMINST VARIANCE LIBRARY IMPACT FEE PARKS IMPACT FEE PERMIT FEE REPORT CODE O PUBLIC BLD IMPACT FEE HABITABLE AREA (RADON) RADON FEE SCHOOL IMPACT FEE GROSS ROAD, IMPACT FEE DUE CREDIT Y N TOTAL ROAD IMPACT FEE SCHOOL IMPACT FEE CREDIT Y N TOTAL SCHOOL IMPACT FEE POLICE FEE FIRE FEE MISC FEE TOTAL POLICEIFIRE MISC FEES ADDITIONAL PERMITS REQUIRED. Y N SPECIFY TOTAL of ALL FEES REVIEWS ZONING ZONING PLANS MISC. VEGETATION SEA TURTLE MANGROVE REVIEWED BY EXAMING DATE 5.104 COMPLETE INITIALS Tioim�� of Forti �� a, �n+c 3503 Ocean Vero Beach, FL 32963 Phone (772) 234-5661 Fax(772)234-5662 TO: St. Lucie County Bldg. Dept. LETTER OF TRANSMITTAL WE ARE SENDING YOU ® Attached ❑ Shop drawings ❑ Prints ❑ Copy of Letter ❑ Change order DATE: r D05 A n la RE: At an Ic le Beach Club Exterior Permit ❑ Under separate cover via ❑ Plans ❑ Samples _the following items: ❑ Specifications COPIES DATE NO. DESCRIPTION i Atlantic View Beach Club Exterior Permit Application for roof permit by The Roof Authority 2 Design pressure calculations & system attachment analysis 2 Roof Authority Drawing Report 1 Letter of Ins ectibn from Roof Asset Management 1 Subcontractor Agreement is 'ID w- W', ows IZaik shop 'D ro WJ Y\j THESE ARE TRANSMITTED as checked below: ® For approval ❑ Approved as submitted ❑ Resubmit copies for approval ❑ For your use ❑ Approved as noted ❑ Submit copies for distribution ❑ As requested ❑ Returned for corrections ❑ Return corrected prints ❑ For Review and comments ❑ ❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS: PLEASE CALL SANDI 772-360=7348 FOR ANY QUESTIONS. Thank you H/D 3IZIv5 Sandi COPY TO: File SIGNED: Terry S. McMillan If enclosures are not as noted, kindly notify us at once. sjh 0