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HomeMy WebLinkAboutSUBMITTED PAPERSDATE: .3 y FEES DUE: RECEIPT #: ��(� (j+� ' Permit #: A ti 03 -0A Planning & Development Services Department Building & Code Regulation Division 2300 Virginia Avenue �c Ft. Pierce, FL 34982-5652 8 /V/�'a Tel. 772-462-1553 �t APPLICATION FOR ROOF PERMIT CUC/eco I—SVE REVERSE SIDE FOR INSTRUCTIONS Unt!. 1. Location/Site Address: 2. Parcel ID Number: • S(�C� ©(� ��� ' [�J(� Office Use Only Section Township Range Map Page Zoning Land Use Initials 3. Description of Project or Work Activity:77-60L, 01-�K4-IN )eelen0/� 4. Total Roof Area (square feet): 2nan 5. Roof Pitch: 5: /_�Z, 6. Type of Roof: [ 4iberglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle ] Tar & Gravel [ ] Modified Bitumen [ ] Other [ vf`Piroduct Approval required for all types of Roofing Material (2 Sets) ] 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 8. Name: MiAou V_RwW of 0 Address: City: eYCE, State: Zip: Phone: 9. Value of Construction: $ 113000 Contractor Information FL Reg/Cert #: f jkl_� I S 15 ,?�fn Jr County Cert #: .23619 Business Name: . A —I _sA 40 Phone• 4(lot, gcgi "Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval. CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all{`pf th information contained in this application is correct and that all work will be done in compli' ice ith all applicable laws regulating construction and zoning. � f PRINT QUALIFIERS/OWNERS NAME SIGNA RE OF QUALIFIER/OWNER STATE OF FLORIDA, COUNT Lon, F, �%' ,O I ACKNOWLEDGED BEFORE ME THIS i DAY OFL 20A, BY 'V�^ WHO IS PERS LLY KN WN TO ME OR HAS P ODUCED AS IDENTIFICATION NOTARY PUBLIC-STATF, OF FLORIDA �' '......Iren S. Nielsen SIGNATUR OF NOTARY TYPE OR PRINT NAME OF NOTARY ssion #DD1000358 �'•DBI Expires: JUNE 12, 2014 COMMISSION NUMBER � p� 4� � 3 j�Nr�EDTIIRUATLAIVTICBONDrNGCO.,IIdq 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 4/26/2010 2014-04-01 13:29 j.a.taylor,�--pofing 772 468 8397 », 7724626443 P 1/1 1 Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 772-462-216S or 772.462-2172 Fax: 772-462-6443 ROOF INSPECTION AFFIDAVIT Re: Permit #Ao'� _ l licensed as �jContractoq /Engineer/Architect (Pleasd print name & circle license type) FS4 It g�lnspector *General, 9ulldlnq, Residential or Roofing Contractor or any Individual certified under 468 F.S. to make such an Inspection. On or about LI did personally inspect the roof deck nailing (D I te) r /� work at: `,(� ri {7' 1'1f(y�. f iqn) F .�; \1 'IW (Job site address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S.) �11 � � Signa re and Seal License # STATE OF FLOR �A COUNTY OF 1 Sworp,to nd subsc Ibed before me this _ da 'f k-)- ' by Who Is pe nally known to me or who has produced as Identification, Notary Public, State of F We t. Signature of Noto Commission Number: (Seal) En 01/19/20I.1 NOTARY PUBLIC•5TATF, OR Pl.ORIDA Karen S. Nielsen �=Commission#171a1000358 $Z,,,,V Expires: JUKE 12, 2014 BONDED TITRv A17 ANMC BONDING CO., IN L RECEIVED APR 0�11014 JOSEPH E. SMITH, CLERK OF - CIRCUIT COURT - SAINT LUCIE COUNTY --, FILE # 3934988 OR BOOK 36- PAGE 181, Recorded 03/18/2014'at 10 AM 57�) NOTICE OF COMMENCEMENT TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS $2,500.00 OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS $7,5Iy0r0�.00 PERMIT #: TAX FOLIO #: J,3�,�, , J'O©�1'p • Lil�tJ' State of Flodda, County of �WtA k LUCIIE, the undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with chapter 713, Florida statutes, the following information is provided in this notice of Commencement. 1. LEGAL DESCRIPTION OF PROPERTY (AND STREET ADDRESS IF AVAILABLE): SS®S LHylr PRIVe RGliq?l PitJF,% %jA �hwSE i- LO+ 55 2. GENERAL DESCRIPTION OF IMPROVEMENT: 3. WNER INFORMATION or []LESSEE INFORMATION (If Lessee contracted for the improvement) a. Name: W\%'\" F., \-MW IIwb Address Z&5 OS �it RGYC-E, �• -[ Q J� b. Interest in property: OWNej?- c. Name and address of fee simple titleholder (if other than owner): 4. CONTRACTOR: a. Name: J. A. TAYLOR ROOFING, INC. Address: 302 MELTON DRIVE, FORT PIERCE, FL. 34982 b. Phone number: 772-466-4040 5. SURETY COMPANY (IF Applicable, a copy of the payment bond Is attached): a. Name & Address: _N/ b. Phone number. Bond amount: 6. LENDER/MORTGAGE COMPANY: a. Name & Address: _N/A b. Phone number: 7. 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: a. Name & Address: _N/A b. Phone number: fax number: 8. IN ADDITION TO HIMSELF OR HERSELF, a. Owner designates _N/A of to receive a copy of the lienor's notice as provided in section 713.13(1) (b), Florida statues. b. Phone number: 9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT: (THE EXPIRATION DATE IS ONE (1) YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED). WARNING TO OW NER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST RE RECORDED AND POSTED ON THE JOE 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 PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF (SECTION 92.525, FLORIDA STATUTES SIGNATUR9 OF OWNER or LESSEE or OWNER'S AUTHORI- ER/DIRECTOR/PARTNER/MA AGER - SIGNAORY'S TITLE, OFFICE THE FOREGOING INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS I T DAY OFf,20A, BY: NAME OF PERSON TYPE OF AUTH ITY NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED ❑PERSONA OWN PRODUCED IDENTIF CATION TYPE Of IDENTIFICATION PRODUCED 6M t'Ii—I�15A1 NOTARY SIGNATURE / NOTARY PRINTED NAME / NOTARY SEAL NOTARY PURTdr. sT ATF. nF FIARTDA ,e""""•; Karen S. Nielsen shd 0M0dssi0n#DD1000358 Expires: JUNE 12, 2014 BONDED THRU ATT.ANTIc BONDING ca., IXC STATE OF FLORIDA ST. L401E COUNTY TRIS IS TO CERTIFY THATTHIS IS TR-4IE "'' CORRECT COPY %-T4E OMG I J 5 P � S I'J41�T : C L �_ v By: bate Property Appraiser - St.Lucie County, FL mar} v 1.annino ox i s,r) Record: I of I Property ldentification Site Address: 5505 Eagle Dr Sec/Town!Range: 12 :345 :39E Map ID: 13/12S Zoning: RS4 011•11c1-ship and Mailim, Owner: Mary F Lannino (LF EST) Address: 5505 Eagle Dr Fort Pierce FL 34951-2306 http://www.pasic.org� �c/prc.asp?prclid=131250000560003 f' PROPERTY RECORD CARD = <11Y'ev Next>,> spee.Ass,nnt 'To xes LNesnplious Permits Hoene Print ParcelID: 1312-500-0056-000-3 Account#: 4205 Use Type: SF Res City/Cnty: Saint Lucie County Sales liffornialion Date Price Code Deed Book/Page 5/4/2006 100 01 WD 2556/2135 1/18/2000 110000 01 WD 1277 / 2561 12/1/1994 88000 00 WD 0931/2753 3/15/1990 92000 00 WD , 0682 / 2026 8/1/1981 77500 00 CV 0362 / 1322 9/1/1980 65200 00 CV 0340 / 2054 11/l/1979 8000 00 CV 0321 / 1669 21 (a81) l..c al Description HOLIDAY PINES S/D-PHASE I- LOT 55 (MAP 13/12S) (OR 931-2753: 1277- 2561: 2556-2135) Assfwstnent 201.1 Total Land. and Building 2013 Final: 94500 Land Value: 14500 Acres: 0.27 Assessed: 91332 Building Value: 80000 Ag.Credit: 0 Finished Area: 1563 SgFt Exempt: 75500 Taxable: 15832 T axes: 782.18 B ILDINC INFOR'VIA Ex tenor Fcaiurea View: RooiCover: _ FS - Fibrglss Shg RooiStruct: HP - Hip EMType: HC - HC YearBIt: 1980 Frame: - Grade: C - C EifYrBlt: 1980 PrimeW all: BS - CB Stucco Storyl-fght: 0010 - 1 Story No.Units: 1 SecWall: - Interior Fcatnrc's BedRooms: 3 Electric: MX - MAXIMUM PnnIntW all: DW - Drywall FullBath: 2 HeatTypc: FHA - FrcdHotAir AvgHt/Fl: 1/213ath: 0 HeatFL16I: ELEC - Electric Prm.Flors: CU - Carpet °/(,A/C: 100 % Ieated: 100 %Sprinkled: 0 Special Fcatilres and Yard Items Land Intormatioit Type Y/S Qty. Units Qual. Cond. YrBlt. No. Usc Type Type Measure Depth ENC2 - POOL ENC-AVG Y 1 736 AV AV 1995 1 0100-SF Res 230 -Front Ft 91 127.6 SWAV - RES POOL AVG Y 1 288 AV AV 1995 PAO I - POOL DK-AVG Y 1 448 AV AV 1995 DWC - Driv-Concret Y 1 720 AV AV 1980 FNW6 - WOOD FEN 6' Y 1 240 AV AV 1999 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED Page 1 of 1 Florida Building Lode unlme F1L,n� COPY e-� t a + a 6 9 k a Fivrida Department ) "CIS Home i Log In 1 User Registration i Hot Topics ; Submit Surcharge j Stats & Farts Pu Busines ofessi�l(#USER: Product Approval Pr Public User Regulation Product Approval Menu > EE24_uct or Apoaication Sean > Qpglicati a is > Application Detail FLir Application Type Code Version Application Status Comments Archived Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method FL10674-RB Sion f 0roved 0 f FBC Staff j BCIS Site Map i Links i Search Owens Corning One Owens Corning Par way Toledo, OH 43659 (740)404-7829 g reg. keeler@owenscom ng. com Greg Keeler greg.keeler@owenscorqing.com Mel Sancrant 1 Owens Corning PKWY! Toledo, OH 43659 (419) 376-8360 ( molcanrrantOnwenscat'nia.com f, �inAsphalt Sng Evaluation Report frorr Florida Professional En 2 Evaluation Report Florida Engineer or Architect Name who Robert J.M. Nieminen developed the Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 09/26/2014 Validated By John W. Knezevich, PE 9 Validation Checkiis Certificate of Independence Referenced Standard and Year (of Standard) Standard ASTM D3161, Class F ASTM D3462 ASTM D7158, Class H Equivalence of Product Standards Certified By Florida Registered Architect or a Licensed Hardcopy Received - Hardcopy Received Year 2006 2007 2007 http://floridabuilding. org/pr/pr_app_dtl-aspx?param=wGEVXQwtDq-`BNbEY5 V %2boQT... 6/ 1.9/2013