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Home My WebLink AboutSUBMITTED PAPERSDATE: FEES RECEIPT N: , Permit III: 1. Location/Site Address: 2. Parcel ED Number: Planning & Development Services Department Building & Code Regulation Division 2300 Virginia Avenue Ft Pierce, FL 34982-5652 Tel. 772-4624553 APPLICATION FOR ROOF PERMIT 9 REVPRSE SIDE 1`01INSTRUCTIONS X VA f )0 1 A).-2 it-ta-- 3r,> 1 -1/1 -000 1- 00015- g-1 V7 Ofrice Use Only I Section I Township I Range I Map Page I Zoning Lud Use Iwtials 10) .13 '-�s lai E I KJ It I I eu 0 1 ylk . I cbln�' I I - 3. Description of Project or Work Activity: OF;�ikv- 'D Fr "t- 4. Total Roof Area (square feet): 5. Roof Pitch: * 3 6. Type of Roof.- fvq'Fiberglass Shingle Concrete Roof Tile Wood Shake/ Shingle [ I Tar& Gravel Modified Bitumen I Other Product Approval required for all types of Roofing Material (2 Sets) All Commercial Roofing requires design by an Engineer or Architect (2 Setsj��th Product Approval attached ils Q1 �/V'�o Roof Mitigation per F.S. 553.844 will be required. st 8 y 7. Owner Information 8. Contractor Information tic/6 CC)tJ'7t Name: t " -5 5- a) � I k A-) '�t k FL Reg/C e-rt #: *--1 6,t(A4 & Address: SJ J AJo,-�, County Cert #: City: state: F(0*rtCt1'q,- Business Name: zip: 'W q 5-1 — Phone: tj & I - / 0 7 Cell Phone: 9. Value of Construction: " a q I �;' 6"-) "Note Dry -in and Final Inspection Required. Additional inspection may be required per Product,Approval. 1111ftn'nPill ' - ' &. cati CONTRACTOR/OWNER'S AFFIDAVFr: I certify that -Qh n a - - -c on is correct and that aH work win be done in ftawpopoll cate laws �,eatvmhg consitruction and zoning. Z&-vIc W ". I e! �-- pREqT QUALEMRSIOWNERS NAME SIGNAQU!W0J-QU%L1F]lE STATE OF FWRWA, COUNTY OF ACKNOWLEDGED BEFORE MOE THIS // DAYOF 20-ZL BY U IS PERSONALLY KNOWN --, TO W 0 MOD?UCEID Fl- - --T� AS EDENTIFICAUON N-\ WZ r 00161 MILOW OF NOTARY TYP-E-D" NOTARY CoNi,;ISSJON # DD 852551 r.XRTJES: Match 22,2013 CON0USSION NVMER hruNotary Public Underwri ers 'rl� .......... NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEA&S 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. Reviwd 412612010 oAwN MILONE -MyC(5MMlSSl0N#DD8M7 KEXPIRES: Match 22 20133 04JW1 III". ft4w Thru Notay Public inoderwr6ft INSTRUCT101"10' 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 i ral location of the property where the building activity is taking place. 2. Parcel ID'Ndmber Indicate the tax identification number of the property where the building activity is taking place. 3. Description of Project or Work Activity Completely d'escrib 6 the building activity to take place. Please indicate if tear -off or shin e over shingle etc. .91 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 koof 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 ofthe work to take place. Total cost of construction includes all material and labor costs associated with the building/constiuction activity. Construction value is used to determine the permit fee. St. :Clnty reserves the right to question and/or modify c t the indid ted value of construction if it is demonstrated that the, submitted figures arenot-consistent with similar ty&s < Y of congiuction. 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 proces ' sing after 4:30 P.1VL For assistance in completing this application, please call (772) 462-1553, d"g reg'uIA"r office, hour§.(&00 AM - 5:00-PM), Monday through Friday. Upon i I ssuance of this permit, required inspections can be scheduled by calling (772) 462-1261. st. Lucie County Roof Permit Appliption rev. 3/1/2009 Planning & Development Services Department Building & Code Regulations 2300 Virginia Avenue Fort Pierce, Florida 34982 ZZ __1' (772) 462-1553 OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT F.S. 489.103 (7) EXEMPTIONS State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must provide direct, on -site supervision of the construction yourself You may build or improve farm outbuildings, a one -family or two-family residence or a commercial building at a cost of under $75,000.00. The building or residence must be for your own occupancy. It may not be built or substantially improved for sale or lease. If you sell or lease a building you have built or substantially improved your self within one year after the construction is complete, the law will presume that you built or substantially improved it for sale or lease, which is a violation of this exemption. You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on your building who is not licensed must work under your direct supervision and must be employed by you, which means that you must deduct F.I.C.A. and withholding tax and provide workers' compensation for that employee, all as prescribed by law. Your construction must comply with all applicabloaws, ordinances, building codes, and zoning regulations. Initial —6 1�� _ Or 51 I understand that the building official and inspectors are not there to design or give advice on how tpmeet the minimum code. Initial 0 �rl CV — I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handled in a civil court with the advice of an attorney. This department will not mitigate any contract disputes. Initial I understand that if I compensate any person or company for work performed they are required to be licensed in this jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost of the license. Initial I understand that if any person that is unlicensed and uninsured gets injured on my construction project - they may be entitled to workmen's compensation. I could be held liable for all doctor, lawyer and relatechnedical cost, which could include loss of wages during recovery from their injury. initial M To qualify for this exemption under this subsection, an owner must personally appear and sign the elding permit application and initial the above. I hereby acknowledge that I have read and understand the above disclosure statement and that I further understand that any violation of the terms of the owneribuilder exemption shall be reported by the Building and Zoning Deparftent o the Florida State Department of Professional Regii� eqgnd.acknowledged on this 71! dayof -�C�( _of20 t Owner/Builder Signature STATE OF FLORI!jJ COUNTY OF The forc going instrument was aclkiiowledgq�befbre me this da f 201 by \ -) n`�. fie,0 //7 A- A .4 - who is persona me, or who has uce Ily Y�Oijdenti *ication.to rn Type or Print Name of Notary g rp, DAWNMILONE Title: Not v Public Commission Number 11 11P Z 6.1.5 MY COMMISSION # 01) 852587 Z .,,i 11 EXPIASS: March 22,2013 SWod Thru Notary Public Undmvdtars SLCPDSD Revised 07/22/20 10 Mond Property Appraiser - St.Lucie Countv-, FL Page I of 1 vl�,� 4u I ip PROPERTY RECORD CARD Wynne Building Corp Record: I of 5 <<Prev Next >> Spec.Assmnt Taxes Exemptions Permits Home Print Property Identification Site Address: 14 LA VILLA WAY B ParcelID: 1301-111-0001-000-5 SecITown/Range: 01 :34S:39E Map ID: 13/01 N Account #: 317 Land Use: PRKG/MOBILE PUD City/Cnty: St Lucie County Zoning: Ownership and Mailing Legal Description Owner: Wynne Building Corp 1 34 39 E 1/2-LESS AS IN ORS 2639-2,263: 2652-2429: 2664-2695: Address: 12804 SW 122nd Ave 2678-378,381: 2688-516: 2701-276: 302 Miami FL 33186-6203 More... Sales Information Assessment 2010 Final Total Land and Building Date Price Code Deed Book/Page 2010 Final: 28724700 Land Value: 9577500 Acres: 318.48 1/1/1980 950000 00 Cv 0324/2491 Assessed: 28724700 Building Value: 19147200 11/1/1978 390000 00 CV 0307/1544 Ag.Credit: 0 Finished Area: 21783 SqFt Exempt: Taxable: Taxes: 597019.9 BUILDING INFORMATION Exterior Features View: RoofCover: ExtType: MHPK - MH Parks YearBlt: Grade: C-C EffYrBIt: StoryHght: 0010- 1 Story No.Units: Interior Features BedRoorns: 1267 Electric: FullBath: 0 HeatType: 1/213ath: 0 HeatFuel: 0/c A/C: 0 %Heated: Special Features and Yard Items Type Y/S Qty. Units Qual. Cond. YrBIt. CNC2 - CONCRETE LOW Y 1 7200 AV AV 1982 CNC2 - CONCRETE LOW Y 1 5952 AV AV 1982 FEN1 - CHAINLINK 10 Y 1 200 AV AV 1982 FEN4 - CHAINLINK4' Y 1 160 AV AV 1982 FEN6 - CHAINLINK6' Y 1 665 AV AV 1982 ASP1 - ASP1 HIGH Y 1 199380 AV AV 1982 CSAV - COM POOL AVG Y 1 2720 AV AV 1982 PA01 - POOL DK-AVG Y 1 6304 AV AV 1982 CURB - CEMENT CURB y 1 695 AV AV 1982 ASP1 - ASP1 HIGH Y 1 360000 AV AV 1982 - RoofStruct: - 1982 Frame: - 1982 PrimeWall: - 1267 SecWall: - PrmlntWall: AvgHt/Fl: - Prm.Flors: 0 %Sprinkled: Land Information No. Land Use Type I 2800-PRKG/MOBILE 176 -Site 0 Measure Depth 1267 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. http://www.pasle.org/pre.asp?prelid=130111100010005 7/11/2011