HomeMy WebLinkAboutSUBMITTED PAPERSSt. Lucie County Building & Zoning
2300 Virginia Avenue Ft. Pierce, FL 34982-5652 i
Tel. 772-462-1553
APPLICATION FOR ROOF PERMIT
1. Loe�tion/Site Address:
2. Parcel ID Number: —
SCANNS®
BY
Or. Lucie
County
Office Use
Only
Section
I Township
Range
I Mae Page
I Zoning
Land Use
I Initials
S
3. Description of Project or Work Activity:
4. Total Roof Area (square feet): r 5. Roof Pitch: ► w'�
6. Type of Roof: [t,] F berglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle
[ ] Tar & Gravel [ ] Modified Bitumen [ ] Other
[ 4 O.A. or Florida - Product 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 er F.S. 553.844 will be required.
7. Owner Infor�r�at;X,
a
Name- d�``))® od 00
Address: -5 0 19� �areA
City: iState•
8. Contractor Information
Zip: Z Phone: 5-W, 3 7/ - �/r Ozpfel
9. Value of Construction: $ 0 06
Note Dry -in and Fynal Inspection Required
Additional inspection may be required per Product Approval
3 Yes
FL Reg/Cert #: C-CC-0�
County Cert #:
Business Name: 2 '� ( C
Fees Due: /. '
Receipt #:
CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all of the information contained ' this ppli atio s rrect and that all work will be
done in compliance with all appli re n ns n and zoning.
PRINT QUALEFIERS/OWNERS NAhW SIGN TU . OF QUALIFIER/OWN
STATE OF FLORIDA, COUNTY OF
_°j BY
ACKNOWLEDGED BEFORE ME TNIS � )AY OF ,
4 20 �`�
WH PERSONALLY KNOWNy TO ME OR HAS PRODUCED AS IDENTIFICATION
W7
SIGNA OF NOTARY TYPE OR PRINT NAME OF NO R�'; ,�Y °" ' Notary
Pu(DY L )Statc f Floridar`� ;�� ; Notary Pu%tm�)State;.of Fl
COMMISSION NUMBER �% — l « . . • My Comm. Expires Jul 6, 2015
=,�� ' +o;: Commission # EE 109424
'••,�; of f :°p`� annaed Through National Notary Assn.
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT R4b4
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Jun 11 12 08:33a Capps Roofing- [no, 779z,946-3418
Planning & DevelOPMent Seirvici-s
SUiWing & Code RLigidaition Division
66
7900 Virifinia Avenue
Fdrt Pierce, FL 34982
.777_462-2165 or 77ZA62-Zi72
..Fax:.-ZjZ
... .......
ROOF INSPEMOK AFFIDAVIT
7�'
NE limit
{P
lease "m to
*General, Bufid1ft9,,RexdeMa1 GrJR001
On or about
work at:
P.1
;V*
r* Xf�fiiiedie/Archlfect
t:1 I= iL
ijt46ff'Rtj1UdjWg tnsp7dqqr
Cwt,,UcWraranylndrwdualaft#kdUnde,F4w.FS-tc-mak-e-sur;"minspection--.....
,.I: did personally inspect.thei-roof-dAcknAIRU -
(Job site address)
Based upon that examination I have determined the installation was done 4ccording to.the.*Hurricane
-Mitigation Retrofit Manual. (Based on 553.844 F.-S.)
T.2
/-Signature and SealLicense #
STATE OF FLORIDA
COUNTY OF
Sworn to a d scrib before me this day of 20
I,-- Who is personally -known to me or who has produced
as lderjjZat�jon.
Notary Public, State of Flow
Signature of Notary.
Commission Number: .(Seal)
RDY
FRAMPTON
0
Notary public - State of Florida
A.
myCoMmIscomm. Expires Jun 4', 2013
as on DO 896434
;j
r ti
Oo?Y7
Permit No.
State of Florida County of St Lucie
NOTICE OF COMMENCEMENT
Tax Folio No. 3/12- 900-0 A - LOX - I
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
on of %ope : (and street ddrgss if available • S
;an] 152+�.A Lid' R't ReRCe L 2- 51 ��• V `'
General description of improvement:
Owner infor ation or Lessee i ormat•on if the Lessee contracted rthe improvemen t;
Name
Address O �� :Aim A/- %0-/lccC C.
QQ
interest in property: S 1�-'e -�
Name and address of fee simple titleholder (if different from Owner listed above):
Contractor's Name: e�PPS
Contractor Address:
Phone Number: -7 �a
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address:Phone number:
Lender Name: Phone Number.
Lender's address:
/10,
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Sectij
713.13(1) (a)7., Florida Statutes:
Name: _
Address:
Phone Number:
In addition to himself or herself, Owner designates of
Lienor's Notice as provided in Section 713.13(1) (b), Florida Statutes.
Phone number of person or entity designated by owner
to receive a copy of the
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Expiration date of notice of commencement: (the expiration 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 CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB 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 knowledge -and belief. _
or Lessee,
Authorized Officer/Director/Partner/Ma
(Signatory's Title/Office)
The foregoing instrument was acknowledged before me this day of�, 2ULZj
By as
Perso Type of authority (e.g. officer, trustee
of
leel A&::—
(Signatur t Notary Public Atate of Florida)
.(Print, Type, or Stamp Commissioned Name of Notary Public)
ROYFRAMPTON
Notary Public - State of Florida
My Comm. Expires Jun 4, 2013
Commission # DD 896434
Party on behalf of whom instrument was executed
Personally known___, or produced Identification e/
7
C
0
0
C
71
I
Type of Identification produceAP/3-'�� I - .0 — 7 Oct
FL *
.Application Type
Code Version
Application Status
Comments
Archived
Product Manufacturer
Address/Phone/Email
0,
Authorized Signature
U
Technical Representative
. Address/Phone/Email
(Quality Assurance Representative
;Address/Phone/Email
I
(Category
Subcategory
;Compliance Method
1 Florida Engineer or Architect Name who
developed the Evaluation Report
Florida License
Quality Assurance Entity
Quality Assurance Contract Expiration Date
Validated By
Certificate of Independence
Referenced Standard and Year (of Standard)
Equivalence of Product Standards
Certified By
FL10674-R6
Revision
2010
Approved
r-
Owens Coming
One Owens Coming Parkway
Toledo, OH 43659
(7.40) 404-7829
greg.keeler@owenscorn.ing.com
Greg Keeler
greg.keeler@owenscorning.com
Mel Sancrant
1 Owens Corning PKWY
Toledo, OH 43659
(419)376-8360
mel.sancrant@owenscornig. co m
Roofing
Asphalt Shingles
Evaluation Report from a Florida Registered
Florida Professional Engineer
r Evaluation Report - Hardcol Received
Robert J.M. Nieminen
PE-59166
Underwriters Laboratorles Inc.
09/26/2014
John W. Knezevich, PE
r Validation Checklist - Hardcopy
Standard
ASTM D3161, Class F
ASTM D3462
ASTM D7158, Class H
rage i of
I Links i Search
or a Licensed
Year
2006
2007
2007
orlduilding.org/pr/pr _app_dtl aspx?param=wGE`TXQuvtDgt$NbE
P..,,. Puilding.org/p
.. 4/9/2012
r'ioricta tsunaing uoae vnime
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 02/16/2012
Date Validated 02/21/2012
Date Pending FBC Approval 02/24/2012
Date Approved 04/03/2012
Summary of Products
FL #
Imodell, Number or Name
Description
10674.1
Owens Coming Asphalt Roofing
3-tab, laminated, starter, and hip &
ridge
Shingles and Starters
Limits of Use
Approved for use in HVHZ: No
Approved for use outside HVHZ: Yes
Impact Resistant: N/A
Design Pressure: N/A
other: Refer to ER, Section 5.
Installation Instructions
FL10674 R6 II er020612FINAL O
FL10674-
i
PE - 59166
Yes
C FL10674-
R6 Asphalt Shin les. df
Verified By: Robert 1. M. Nieminen
Created by Independent Third Part,:
Evaluation Reports
FL10674 R6 AE er020612FINAL I
R6 Asphalt Shinoles.odf
Created by Independent Third Pa
: Yes
Back Next
Contact Us:: 1940 North Monroe Street Tallahassee RL 32399 Phone: 850487-1824
The State of Florida is an WEED employer. Copyright 2007-2010 State of Florida.:: Privacy Statement :: Accessibility Sta ement :: Refund Statement
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a p lic-records request, do not
send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions riling DBPR's ADA web
accessibility, please contact our Web Master at webmariteradbDr.smote fl . I(
Product Approval Accepts: l
® ® e'Clie"cli M
sccurit nrSTxres
Verl$lg� r
�rurbd ,
vuVr r
http //;:w'W oridabuilding.org/pr/pr_app_dtl.aspx?param=w , V. . 0WtDgtBNbEY5 %2b... 4/9/2012
6.3.5 Minimum Nailing - WeatherGuard@ HP Hip and Ridge:
Fig. A v 4
F— Cftedbn A
A
Nair 4 4
A
A I I
I 1
1 I
I I
A I I
P
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�E>rpoaule
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Halm I Nalr
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7. LABELING: lity,
7.1 Each unit shall bear a permanent label with the manufacturer's name,logo, state and logo
of the Accredited Quality Assurance Agency noted herein.
7.2 Asphalt shingle wrappers shall indicate compliance with one of the req : ired classifications
detailed in FBC Table 1507.2.7.1 / R905.2.6.1.
S. BUILDING PERMIT REQUIREMENTS:
As required by the Building Official or Authority Having Jurisdiction in order to pry perly evaluate the
installation of this product.
9. MANUFACTURING PLANTS:
Contact the named QA entity for information on which plants produce products cov I ed by Florida Rule
9N-3 QA requirements.
10. QUALITY ASSURANCE ENTITY:
Underwriters Laboratories - QUA1743; (414) 248-6409; karen.buchmann@ul.com_
- END OF EVALUATION REPORT -
Exterior Research and Design, LLC. Evaluation Rort 037940.02.12
Certificate of Authorization #9503 FL10674-R6
Date of Iss' ance: 02/06/2012
Page 6 of 6
_kw
6.2.9 Minimum Nailing - WeatherGuardp HP:
6.3 Hip & Ridge Shingles:
6.3.1 Installation of Berkshire® Hip and Ridge Shingles, High Ridge, Hip & RidgE with Sealant and
WeatherGuard® HP Hip and Ridge Shingles shall comply with the man facturer's current
published instructions, using four (4) nails per shingle. Refer to Owens Zorning published
information on wind resistance and installation limitations, including the use If hand -sealing for
wind warranties.
6.3.2 Fasteners shall be in accordance with the manufacturer's published require ents, but not less
than FBC 1507.2.6 or R905.2.5. Staples are not permitted.
6.3.3 Minimum Nailing - Berkshire® Hip & Ridge and High Ridge: j
6.3.4 Minimum Nailing - Hip & Ridge with Sealant:
em Fig. 2 - High Wk d Fas>belmg Pact m
(4'N NO
rim- Shingle
nd �
Discard
Exceem 1w. I..
Sealant
Strip 12"
' Fastening 5S/a" 5"Exposure
Distance
12"
Exterior Research and Design, LLC.
Certificate of Authorization #9503
Fig. 2
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Nits
T
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Top Lrltlnaled
Pfem
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Evaluation
Date of
Sldevlew
037940.02.12
FL10674-R6
;: 02/06/2012
Page 5 of 6
6.2.6
6.2.7
6.2.8
Minimum Nailing - Berkshire@:
Minimum Nailing - Duration@ & Duration@ Prer
4 Nal Mom
Esqumw do 4 davos
Swepaia6stlning ama WkIth
Area de dawsSuWUP
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Minimum Nailing - OakridgeO:
4 Nail Paft*n
Eswom cm 4 days
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Eryasidh�de86/BPu(g
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Exposlaida da 6 &(Spdg
Exterior Research and Design, LLC.
Certificate of Authorization #9503
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Evaluation RepLrt 037940.02.12
FL10674-R6
Date of Issu ice:02/06/2012
Page 4 of 6
ih
Properly Appraiser - St.Lucie County, FL
Page 1 of 1
PROPERTY RECORD CARD
Ronald E Svoboda
Record: 1 of 1
<<Prev Next» Spec.Assmnt
Taxes Exemptions Permits Home Print
Property Identification
,�GIE Co
Site Address:
5104 INDIAN BEND LN
ParcellD:
1312-800-0012-000-4 � G2
Sec/Town/Range:
13 :34S :39E
Account #: 4423
Map ID:
Zoning:
13/13N
RS-4
Land Use: SF Res
City/Cnty: St Lucie County
Ownership and Mailing
Legal Description
Owner.
Ronald E Svoboda Lee Ann Svoboda
HOLIDAY PINES S/D-PHASE II -A- LOT 181 (MAP 13/13N) (OR 3321-
Address:
5104 Indian Bend Ln
1427)
Fort Pierce FL 34951-2389
Sales Information
Assessment 2011 Final
Total Land and Building
Date
Price Code Deed
Book/Page
2011 Final: 142000
Land Value: 14700 Acres: 0.31
9/2/2011
187500 0001 WD
3321 / 1427
Assessed: 131443
Building Value: 127300
3/11/2009
100 0130 WD
3069 / 1998
Ag.Credit: 0
Finished Area: 2160 SgFt
5/16/2007
100 01 QC
2839 / 0504
Exempt: 50000
7/11/2000
21900 00 WD
1313 / 1516
Taxable: 81443
2/23/1999
14500 01 WD
1205 / 0581
Taxes: 1853.94
6/7/1995
22000 00 WD
0960 / 2411
10/1/1979
19950 00 CV
0319 / 1029
BUILDING INFORMATION
Exterior Features
View: -
RoofCover.
ExtType: HC+ - HC+
YearBlt:
Grade: C+ - C+
EffYrBlt:
StoryHght: 0010 -1 Story
No.Units:
Interior Features
BedRooms: 3
Electric:
FullBath: 2
HeatType:
1/2Bath: 0
HeatFuel:
%A/C: 100
%Heated:
Special Features and Yard Items
Type Y/S Qty.
Units Qual. Cond
ENC2 - POOL ENC-AVG Y 1
1354 AV AV
SWAV - RES POOL AVG Y 1
336 AV AV
PA01 - POOL DK-AVG Y 1
1018 AV AV
SDSF - SITE DEV S-F Y 1
1 AV AV
SD - Dim Shingle
RoofStruct:
2001
Frame:
2001
PrimeWall:
1
SecWall:
MX - MAXIMUM
FHA - FrcdHotAir
ELEC - Electric
100
Land Information
YrBlt.
No. Land Use
2001
1 0100-SF Res
2001
2001
2001
HP - Hip
BS - CB Stucco
PrmintWall:
DW - Drywall
AvgHt/FI:
Prm.Flors:
CT - Tile -Ceramic
%Sprinkled:
0
Type
Measure Depth
BCDS-Front Ft
84.48 161.7
THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED.
http://www.paslc.org/paslc/prc.asp?prclid=131280000120004 5/18/2012