HomeMy WebLinkAboutAPPLICATION FOR ROOF PERMITPlanning & Development Services Department
Building & Code Regulation Division '?eCEsVED
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
Tel.772-462-1553 ,APR / C
APPLICATION FOR ROOF PERMIT ZP16
SEE REVERSE SIDE FOR INSTRUCTIONS SCANNED
1. Location/Site Address: 2950 Rosser Blvd Port St Lucie, FI 34953 Ry
2. Parcel ID Number: 4314 -50-L- oo is -W&-y St. Lucie
Office Use
Section
Township
Range
Map Page
Zoning
Land Use
Initials
Only
MW
3. Description of Projector Work Activity: ItiE'ROOE OF �Kt5-ytgu Moo. 01T, L-MR Md(a, 1�1t'T.�
4. Total Roof Area (square feet): 1$735. Roof Pitch:
6. Type of Roof- [ ] Fiberglass Shingle [ ] Concrete Roof Tile
[ ] Tar & Gravel 0;Modified Bitumen
F�Ai
[ ] Wood Shake / Shingle
[ ] Other
[ x] Product Approval required for all types of Roofing Material (2 Sets)
[x ] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product
Approval attached
** Roof Mitigation per F.S. 553.844 will be required.
7. Owner Information
Name: St. Lucie County
Address: 2300 Virginia Avenue
City:
Zip:
Ft. Pierce State: Florida
34982 Phone: 772-462-1400
9. Value of Construction: $ 158,100
8. Contractor Information
FL Reg/Cert#• CCC1325862
County Cert #:
Business Name: Therma Seal Roof Systems, LLC
Cell Phone: 561-719-2653
"Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval.
CONTRACTOR/OWNER'S AFFIDAVIT: I certi .that all o e.info a ' n contained in tImpel
' licati is correct and that all work will be
fY P
done in comp ' c� with III 1 plj�able la}vs r,� ul� g co ruction and zoning.
Dave Wikel
PRINT QUALIFIERS/OWNERS NAME
STATE OF FLORIDA, COUNTY OF Palm Beach
ACKNOWLEDGED BEFORE ME THIS � DAY OF I L 20�0 BY
Dave Wikel
WHO IS PERSONALLY KNOWN )00( TO ME OR HAS PRODUCED AS IDENTIFICATION
^
SIGNA OF NOTARY TYPE OR PRINT NAME OF NOTARY 'Yt(se=;(lL+
FF 042521COMMISSION NUMBER - -t4, 2017�amnce 0M�857019
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 YOUR LENDER OR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Revised 4/26R010