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HomeMy WebLinkAboutROOF PERMIT APPLICATIONDate: a Oa Q Fee Due: j, •� D receipt# .f5— Dermit # St. Lucie County Building &Zoning I� p1 < 2300 Virginia Avenue FL Pierce, FL 34982-5652 SCANNED Tel.772-462-1553 BY �oRlo APPLICATION FOR ROOF PERMIT St. Lucie County p SEE REVS SE SIDE FOR INSTRUCTIONS 1. Location/Site Address: 10 3z i G e S C',7�r t��rf t errr �� 3 t F�l 8 Z - 2. Parcel ID Number: Office Use Section I Township Range I Map Page I Zoning Land Use I Initials Only Q-� (:( u©L _3Mex 7-)' e-4tL I w 3. Description of Project or Work Activity: 4. Total Roof Area (square feet):. 7 9" 6. Type of Roof: l El Fiberglass Shingle []Tar & Gravel ❑ Other (specify) In91 Ly 61E s- 5. Roof Pitch: ❑Barrel/I'ile Ceramic ❑Modified Bitumen ❑l Wood Shake Shingle [ Metal N.O.A - Product Approval required for All Types of Roofing Material All Commercial Roofing Requires Design by an Engineer or Architect (two Sets) e, . 7. Owner Information S. Contractor Information. Name: V r,( e-J-I s Sff 1 FL Reg/Cert #: CCC�p o(qQ Address:) O 3 q 1 M e`ro pt/e- County Cert#: f� 0 City: j'f 6ice State: 1' Business Name: OP�S 3�F�tB2 Phone:��2 g442�0)&6-5 `Cr-1 .7(F-3 Zip: Phone:)-) Fax 9. Value of Construction: Note: Dry -in and Final Inspection Required. Additional inspection may be.required per Product Approval 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. IR /�LS WLUJ' V- S PRINT QUALIFIERS/OWNERS NAME SIGNATURE OF QUALIFIERIOWNER � 9 STATE OF. FLORIDA, COUNTY OF ACKNOWLEDGED BEFORE ME THIS DAYOF C WHOIS PERSONALLYKNOWN OR WHO HAS PRODUCED �20 r7TOME S AS IDENTIFICATION. � (Seal) SIG TORE OF NOTARY U TYPE OR PRINT NAME OF NOTARY TITLE: NOTARY PUBLIC COMMISSION NUMBER _ St. Lucie County Roof Permit Application rev. 7118/05 dmg NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RJ SS LT -IN YOUR PAYING. TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. EXEMPT: A/C - HEAT REPLACEMENT WITH CONTRACT UNDER $5,000. INSTRUCTIONS Please complete all information in the space provided. All information must be printed (use black or blue ink only) or. typed. This roof permit application is to be used only for those.activities that are not otherwise included under a primary building permit. This application may not be used for any activity that includes structural alteration. Building:activities involving, structural alteration in addition to the roof work, 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 where the building activity is taking place. 2. Parcel ID Number Indicate.the tax identification number of the property where, the building activity, is taking place. 3. Description of Project or Work Activity Briefly describe the building activity to take place. 4. Total Roof Area Indicate total roof area to be affected by this permit. Also indicate the pitch of the roof, expressed as a standard ratio of run rise. 5. Type of Roof Indicate the type of roof being repaired or resurfaced. �. 6.Owner Information Indicate the name and,address of the owner of the property on which building activity is taking place. 7. Contractor Information Indicate the State of Florida registration number (if, applicable), St.-Lucie'County contractor license number and the name of the business doing the work. 8. Value of Construction Indicate the total value of the work to take place. Total cost of construction includes all material and labor costs associated with the building/construction activity. ' Construction value isusedto determine the permit fee. 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. This application can be submitted to St. Lucie County Building and Zoning, 2300 Virginia Avenue, Fort Pierce, FL 34982. All permit applications must be filled out completely before submission. No applications will be accepted for processing after 4:30 P.M: For assistance in completing this application, please call (772). 462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday. Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261. St. Lucie County Roof Permit Application rev. 7/18/05 dmg