HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE I FO MU 'T BE COMPLETI DR APPLICATION TO BE ACCEPTED
Date: 1 7 Permit Number: r
SCANNED
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITAPPLICATION FOR:
Address: 3:�s5 S 6 ("iiy t'OSo 13 LAa
Legal Description: &— V O 0-F S I. 1 P
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side:
Residential
to>hItoc
Left Side:
MUUI UVIId1 WUIK LV UC PC IUI II ICU unUCI uun Pen IIIL—Lnecrt du UlaL apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 300
Cost of Construction; $
_0 0
fl
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Block No.
—Windows/Doors
GED
Building Height:
q
� �
Name. o%�c�. cJ
Name--rGtlllP✓`-'6'('�S:
Address: "2S-78; S Z17' S
Company: S&
Address: D '' -W
06 ,/.""
N-» U
City: ��%/�' o'T7 Stater
Zip Code: 020 %/ Fax: `
Phone No.�% OGG-
City: in, tiGLC
Zip Code: Q
Phone No
f C State:-F-1
Fax
E-Mail: JV0 N hL�,,wa.1 &-v7-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail
lei cjEtkLdi
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. 01-1�1 G�
l,r 1 AI '~.tr, ,r I (.<.jY rrr(rfgtaar+<` tY r,E t�Hr t,t;,+t4}� il',r',1-61'�Y'1l •' cr,x. � .. ,
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signa urea of Owner/ Agent/ Lessee/Contractor
Wriature of Contractor/License Holder -
STATE OF FLORIDA _
STATE OF FLORIDA C -
COUNTY OF _ _-5 o t VI C r) CkA-
-
COUNTY OF
me
The forgoin instrument MJLIwas c� le 0J by
this = day of 20 b
me
The forgoing instrument�V was 0 3z,- le 61Y by
this day of A-rYi.i'�/ 20 b
-o
'65412 Z W (.SAGA
Sobs
(Name acknowledging)
(Name of person acknowledging)
�off�person
(Signature of Notary Pub' State of Florida)
(Signature of Notary Pu li - State of Florida )
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identificati n
Type of Identificat
Produced eta9 pa tsArS�aldorAol9a�
Type of Identification
Produced +Po, Notary Public Slate of Flonda
any •
694YdM_s£E00b9,
no
My omisionEE9 64969
94/
9�1COmmissionNO.
COmmI5510n NO. Expre46t6
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT — SAINT LUCIE COUNTY
_•
FILE H 4015206 OR BOOK 36r c?AGE 2123, Recorded 11/20/2014 at 09 AM
i.
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
Stateof Flodda County of St. Lucie
The undersigned hembygives notice that Improvereentwlll be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the fallowing Information is proMed In this Notice of Commencement
Legal Aesciptlon o(.Property: (and goeet address if pvallable),.
General desorption of
the Lessee contracted for the Improvement:
Name
Address 'L.r c c _ tJ
Inlnrnar In n.nw.t.,- /
Name and address of fee simple titleholder (if different from Owner listed above):
Contractors
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address: Phone number:
Lender Name: Phone Number:
Lenders address:
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section
713.13(1)(a)7., Florida Statutes:
Name: Phone Number:
In addition to himself or herself, Owner designates of to receive a copy of the
Uenoes Notice as prpMded in Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner.
Expiration date of notice of commencement: (the expiation date may not be before the completion of construction and final payment to the
contractor, but will be 1 year from the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND WJ RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE 10B SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my kngwledge)nd belief.
(Signature of OwpEr or Lessee, or Owners or lessee's Authorized Officer/Director/Partner/Manager
(SignatoNsTitle/Office)
The fore oing Instrument was acknowledged before me this 20 dayofi�^6'1201(4
By Qrlfi lk GLti�.t as r'0Q`u mr ;SOSc Ax 7.u(tXtri�t
vntNameof Person Type pf authodry(.g. officer, trustee) Parry on behalf of whom instrum
wasexecutetl
✓� ry NObry Pudc Smma(FbMa Personallyknown�el produced Identification_
(Signature of Notary Pubic ot"
State of Flari IP k Maria Malano
(Print, Type, or Stamp Co 'ssioned Nam NM PANQsmmisuo^EEaWOea Type of Identification produced
La, rExpaer MnNrlOta
STATE OF FLORIDA
ST. LUCIE COUNTY
THIS IS TO CERTIFY THAT THIS IS A
TRUE AND CORRECT COPY OF THE
ORIGINAL,
�JO E.SMITH, ERK
Date:
�POV` 2014
C6UNTY
IF1
.O
R
I D-A
Re: Permit#
Planning & Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax:772-462-6443
ROOF INSPECTION AFFIDAVIT
I.PUI b/z. <iy� licensed asa(n)Contractor"/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
*Generol, Building, Residential or Roofing Contractor orany individual certified under 468 F.S. to make such an Inspection.
On or about I ? Z 3 I did personally inspect the roof deck nailing
(D te)
1
work at: 7'15 S f A 17'4%S ' %7 LL 1/
(Job site address)
Based upon that examination I have determined the installation was done according to the current
edition of the Florida Existing Building Code Section 611 or the product approval submitted (whichever is
most strigent).
Signature and Seal
STATE OF FLORI
COUNTYOF Ri
�-�-
License #
Sworn to and subscribed before me this � day of N 6 b 20J4/
bY. V I EK 5(i'I i� Who Is personally known to me or who has produced
as identification.
Notary PWm Stale of Florda
Notary Public, StateoF orida �j Maria Marano
Signature of Notary: �t 1j, 1 i�.1 1/ r do Aly Commission EE064069
B ry: /t./1 G h ' �` ern Eypves04042015
Commission Number. (Seal
En 01/19/2011
L'd L60t-8L9-ZLL sloloeiluoO buuooy spas
r- -
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER)
BOARD AND CODE ADMINISTRATION DIVISION
NOTICE OF ACCEPTANCE
GAF
1361 Alps Road.
Wayne, NJ 07470
MIAMI-DADE COUNTY
PRODUCT CONTROL SECTION
11805 SW 26 Street, Room 208
Miami, Florida 33175-2474
T (786) 315-2590 F (786) 315-2599
w v.miamidade.cov/economy
File COPY
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The
documentation submitted has been reviewed and accepted by Miami -Dade County RER - Product Control Section to be
used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section
(In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this
product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted
manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or
suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance,
if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the
requirements of the applicable building code.
This product is approved as described herein, and has been designed to comply with the Florida Building Code
including the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION: GAF Royal Sovereign Shingle
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following
statement: "Miami -Dade County Product Control Approved", unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change
in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the
materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product,
for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section
of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the
expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done
in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and
shall be available for inspection at the job site at the request of the Building Official.
This renews and revises NOA #12-0313.11 and consists of pages 1 through 4.
The submitted documentation was reviewed by Alex Tigera.
NOA No.: 12-1127.03
MLAMI-DAD' COUNTY Expiration Date: 04/22/18
Approval Date: 04/18/13
Page 1 of 4
ROOFING ASSEMBLY APPROVAL
Category:
Roofing
Sub -Category:
Asphalt Shingles
Materials
3-Tab
Deck Type:
Wood
SCOPE
This approves GAF Royal Sovereign® Shingle as manufactured by GAF as described in this Notice of Acceptance,
designed to comply with the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building
Code.
PRODUCT DESCRIPTION
Product Dimensions
GAF Royal Sovereign Shingle 12" x 36"
MANUFACTURING LOCATIONS
1.
Savannah, GA.
2.
Tuscaloosa, AL.
3.
Tampa, FL.
4.
Mt. Vernon, IN.
5.
Mobile, AL.
6.
Dallas, TX.
7.
Myerstown, PA.
8.
Fontana, CA.
9.
Minneapolis, MN.
EVIDENCE SUBMITTED
Test Agency
Center for Applied Engineering
PRI Asphalt Technologies, Inc.
PRI Construction Materials Technologies, Inc.
Underwriters Laboratories, Inc.
Test Product Description
Specifications
TAS 110 Fiberglas reinforced heavy weight asphalt roof
shingle, with a 3-Tab profile
Test Identifier
Test Name/Renort
Date
TAS 100
02/23/94
ASTM D3462
257966
03/21/97
TAS 100
GAF-105-02-01
11/14/05
TAS 100
GAF-182-02-01
02/07/08
TAS 100
TAS 100
TAS 100
TAS 107
TAS 107
TAS 107
TAS 107
TAS 107
ASTM D 3161 / TAS 107
ASTM D 3161 / TAS 107
GAF-332-02-01
01 / 17/ 12
GAF-376-02-01
10/15/12
GAF-153-02-01
11/30/06
05CA48258
11/28/05
05CA47804
11/11/05
08NK02337
03/12/08
08NK12906
10/10/08
11 CA47919
12/03/11
09CA41642
09/28/10
09CA38549
10/30/09
NOA No.: 12-1127.03
Expiration Date: 04/22/18
Approval Date: 04/18/13
Page 2 of 4
ASTM D
3462
ASTM D3462
09/12/06
ASTM D
3462
08NK02337
03/12/08
ASTM D
3462
09CA21715
05/20/09
ASTM D
3462
08CA61515
07/15/09
ASTM D
3462
11CA47919
12/03/11
LIMITATIONS
1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for
fire ratings of this product.
2. Shall not be installed on roof mean heights in excess of 33 ft.
3. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code
and Rule 9N-3 of the Florida Administrative Code.
INSTALLATION
1. Shingles shall be installed in compliance with Roofing Applications Standard RAS-115.
2. Flashing shall be in accordance with Roofing Applications Standard RAS-115.
3. The manufacturer shall provide clearly written application instruction.
4. Exposure and course layout shall be in compliance with Detail "A", attached.
5. Nailing shall be in compliance with Detail "B", attached.
LABELING
1. Shingles shall be labeled with the Miami -Dade Seal as seen below, or the wording "Miami -Dade County
Product Control Approved".
BUILDING PERMIT REQUIREMENTS
1. Application for building permit shall be accompanied by copies of the following:
1.1 This Notice of Acceptance.
1.2 Any other documents required by the Building Official or the applicable code in order to properly
evaluate the installation of this system.
NOA No.: 12-1127.03
Expiration Date: 04/22/18
Approval Date: 04/18/13
Page 3 of 4
04
<T
DETAIL A
COURSE LAYOUT
DETAIL B
OVERALL DIMENSIONS AND NAILING PATTERN
K�
END OF THIS ACCEPTANCE
MIAMIDADE COUNTY NOA No.: 12-1127.03
... , , Expiration Date: 04/22/18
Approval Date: 04/18/13
Page 4 of 4