HomeMy WebLinkAboutSUBMITTED PAPERSDATE:—rc I jFEES DUE: RECEIPT #:
Planning & Development Services Department
Building & Code Regulation Division i
2300 Virginia Avenue
Ft Pierce, FL 34982-5652
Tel. 772-462-1553
APPLICATION FOR ROOF PERMIT St.
SEE REVERSE SIDE FOR INSTRUCTIONS
1. Location/Site Address:
2. Parcel ID Number: -:2-Li �>C) 5 G Z ®O (o L-I 0 00
O'
SCANNED
BY
Lucie-ncl, ,
Office Use
Only
I Section
LTownsbip
I Ran a
Mall Page
I Zoning
Land Use
Initials
o
3
o r✓
3Q
R q
3. Description of Project or Work Activity: c' q e C' rr o C o
4. Total Roof Area (square feet): o o 5. Roof Pitch: G 12-
6. Type of Roof.- V] Fiberglass Shingle [ J Concrete Roof Tile [ J Wood Shake / Shingle
[ ] Tar & Gravel [ ] Modified Bitumen [ J Other
[ J 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 per F.S. 553.844 will be required.
7. Owner Information 8. Contractor Information
Name: "C"L FL Reg/Cert #: ,
Address: 52 0 County Cert #:
City: Stater Business Name:
Zip: 34 . % l Phone: S (- 6 S �► �� S- Cell Phone: -7,
9. Value of Construction: $ �, E O D
**Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval.
CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all of the information contained in this application is coned and that all work will be
done incompliance with all applicable laws regulating construction and zoning.
•
PRINT QUALHURSIOWNERS NAME SIGN OF QU R/OWNER
STATE OF FLOREDA, COUNTY OF S
ACKNOWLEDGED BEFORE ME THIS _a_0 DAY OF 20_ L, BY
WHO IS FERSONAILLY KNOWN TOAN OR PRODUCE ✓�-_L71_ntil `os i `cam Aa lYLj1111. AllVl
,err ny ANOEIA M. HUFF
SIGNATORE OTARY TYPE OR"OR"M NAME OF NOTARY ( _ r_ MY CAMMISSION I EE 083530
EXPIRES; April 12, 2015
COMDIISSION NUMBER Wnded Thru Notary Pubic UW wftm
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. tF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Revised 4/26t2010
INSTRUCTIviiS
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
2. Parcel ID Number
3. Description of Project or Work Activity
4. Total Roof Area
5. Type of Roof
6. Owner Information
7. Contractor Information
8. Value of Construction
Indicate the street address or general location of the
property where the building activity is taking place.
Indicate the tax identification number of the property where
the building activity is taking place.
Completely describe the building activity to take place.
Please indicate if tear -off or shingle over shingle etc.
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.
Indicate the type of roof being repaired or resurfaced.
Indicate the name and address of the owner of the property
on which building activity is taking place.
Indicate the State of Florida registration number (if
applicable), St. Lucie County contractor license number and
the name of the business doing the work.
Indicate the total value of the work to take place. Total cost
of construction includes all material and labor costs
associated with the building/construction activity.
Construction value is used to determine the permit fee. St.
Lucie County reserves the right to question and/or modify
the indicated value of construction if it is demonstrated that
the submitted figures are not consistent with similar types
of construction.
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 processing after 4:30 P.M. For assistance in completing this application, please call (772)
462-1553, during regular office hours (8:00 AM - 5:00 PM), Monday through Friday.
Upon issuance of this permit, required inspections can be scheduled by calling (772) 462-1261.
St Lucie County Roof Permit Appticetion rev. 3/1/2009
Planning & Development Services Department
• Building & Code Regulations
s 2300 Virginia Avenue
�» Fort Pierce, Florida 34982
,' a g — ' fir
(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 applicable laws,
ordinances, building codes, and zoning regulations. Initial ^' (-\
I understand that the building official and inspectors are not there to design or give advice on how to meet
the minimum code. Initial ,g8L —
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 44 lP-
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� O�
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 related medical
cost, which could include loss of wages during recovery from their injury. Initial 1
To qualify for this exemption under this subsection, an owner must personally appear and sign the building
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 owner/builder exemption shall be reported by the Building and
Zoning Department to the Florida State Department of Professional Regulation. Signed and acknowledged on this
��day of ')- D of 20 A. t i1 A n
Ovoirft/13uilder Si&ore
STATE OF FLORIDA
COUNTY OF � u c�k E—
The foregoing instrument wa acknowledged before me this day of 0 , 20 1,
lb who ipersonally known to me, or who has
( as identification.
y Type or Pr t Name of Notary Sealic Commission Number ANGELA M. HUFF
MY COMMISSION # EE W -7 0
:Q EXPIRES: April 12, 20'i'.)
SLCPDSD Revised 07/2212010 � ?�° Bonded Thru Notary Public
UUbLYH X. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE $ 3639501 OR BOOK 3333 $753, Recorded 1-0/20/2011 at 10:131
AFTE ALLQDINGRETCRNTQ
PERMIT VUMn
NOTICE OF COMMENCEMENT
The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713.
Florida statutes the following information is provided in the Notice of commencement.
� oo `� 000y
1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX ULIO NUMBER: =`a V SU Z ' )
SUBDIVISION WL Jrt BLOCK _TRACT LOT�BLDG UNIT
2. GENERAL DESCRIPTION OF IMPROVEMENT: -
3.OWNER INFORMATION: a. Name y A Z
b. Address 3 Zb k 9-t t) e. r 17 t- t ve F4 PC PAGE' - c. interest in property
d. Name and address of fee simple titleholder (if other than owner) }
4. CONTRACTOR'S NAME, ADDRESS AND PHONE NUMBER
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND 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:
NAME., ADDRESS AND PHONE NUMBER: _mil �% 4 1!-l-
8. in addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER: -
9. Expiration date of notice of commencement (the expiration date is I year from the date of recording unless a different date is
specified)_ _ _ 20�-------._..__...�,.�..,,.......,.-r..
Print Name and �Provide Signatory's Title/Offire
Owner's Authorized
State of Florida
County of A +
The fo goin instrument was acknowledged before me this (fl day of ' 20
By (Na of person) } L (Type of authority... e.g. Owner, officer, trustee, attorney in fact)
For i:Zr' `0 M ` ' 1 - of
(Name of parWon behalf of whom instrument was executed) Personally Known., or produced the following type ID: s•-' L
I t ryj ANOI:L/1M.HUFF
S ( �' MY COMMISSION I EE W35W
1
l J 1�1 �.-� ( �` %• EXPIRES: Apnl 12, 2015
' f g .,.
(Printed Na of Notary Public) (Signature o iotary Public) i >,q�;n4'e aaaee Tm,NouryPuaicUMawaas
Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are tme to the best of my knowledge and
belief (section 92.525. Florida Statutes).
Signature(s) of Owner(s) or Owner's)' Authorized Officer/Director/Partner/Manager who signed above:
ey: _ By
a.. nowt to:«a,yt t
STATE OF R ORIDA
ST. LUCIE couNTY
THIS rn nrn-i ICV TUATT141S tS 1
TRU
ORI
By:
Dal
14IAMI a
MIAl1It-DADE COUNTY
PRODUCT CONTROL SECTION
BI-)ILDING AND NEIGHBORHOOD CO LI D TM 11805 SW 26 Street, Room 208
BOMD AND CODE ADMINISTRATION I Miami, Fiorida 33175-2474
T 86) 315-2590 F (786) 315-2599
N OFICE OF ACCEPTANCE (NOA)1 (� � � G)C� wiyiv.miamidade.eov/building/
0 vveas Corning Roofing and Asphalt, LLC
OrieDwens Corning Parkway
Toledo, OH 43659
SCOPE:
Th isNOA is being issued under the applicable rules and regulations governing the use of construction materials.
Tft e documentation submitted -has been reviewed by Miami -Dade County Product Control Section and accepted
by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by
the Authority Having Jurisdiction (AHJ).
ThisNOA 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, BORA
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: Oakridge® 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 NOA consists of pages I through 4.
The submitted documentation was reviewed by Alex Tigera.
O X��Ur NOA No.: 10-1015.01
MIAMI•DADECOUNTY Expiration Date: 02/03/16
Approval Date: 02/03/11
Page l of 4
]ROOFING ASSEMBLY APPROVAL
Cateory:
S ub-Categorv•
_Materials
D►ec�k Type:
SCOPE
Roofing
Asphalt Shingles
Laminate
Wood
This approves a roofing system using Owens Corning Oakridge(g) asphalt shingles manufactured by Owens
Goning as described in Section 2 of his Notice of Acceptance.
PRODUCT DESCRIPTION
Product Dimensions Test Product Descriation
Specifications
Oakridge® 13 '/," x 39 3/8" TAS 110 A heavy weight, fiberglass reinforced
ifanufacturing laminate asphalt shingle with continuous
Locations #1, 2, 3, 4 bead of sealant,
Omkridge® 13 '/," x 39 3/R" TAS 110 A heavy weight, fiberglass reinforced
Afonufacturing laminate asphalt shingle with dashed bead of
Location 44 sealant.
NIANUFACTURING LOCATION
1. Memphis, TN
2. Irving, TX
3. Savannah, GA
4. Jacksonville, FL
EVIDENCE SUBMITTED
Test AizencY
Test Identifier
Test Name/Report
Date
PRJ Construction Materials Technologies
OCF-153-02-01
TAS 100
09/22/10
PRJ Construction Materials Technologies
OCF-152-02-01
TAS 100
09/21/10
PRI Construction Materials Technologies
OCF-158-02-01
TAS 100
11/10/10
PPU Construction Materials Technologies
OCF-151-02-01
TAS 100
09/27/10
PRJ Construction Materials Technologies
OCF-150-02-01
TAS 100
09/21/10
Underwriters Laboratories
09NK14530
ASTM D 3462
12/31/09
Underwriters Laboratories
R2453
ASTM D 3462
10/11/10
Underwriters Laboratories
R2453
ASTM D 3462
11/03/10
Underwriters Laboratories
R2453
ASTM D 3462
10/11/10
Underwriters Laboratories
R2453
ASTM D 3462
10/11/10
Underwriters Laboratories
R2453
ASTM E 108
01/13/11
Underwriters Laboratories
R2453
ASTM E 108
10/11/10
Underwriters Laboratories
R2453
ASTM E 108
11/03/10
Underwriters Laboratories
R2453
ASTM E 108
10/11/10
Underwriters Laboratories
R2453
ASTM E 108
10/11/10
NOA No.: 10-1015.01
MIAMI•DADE COUNTY
Expiration Date: 02/03/16
Approval Date: 02/03/11
Page 2 of 4
Underwriters Laboratories
09NK14530
TAS 107 (ASTM D 3161)
12/31/09
Underwriters Laboratories
OINK44201
TAS 107 (ASTM D 3161)
09/09/02
Undetivriters Laboratories
IONK13947
TAS 107 (ASTM D 3161)
11/12/10
Underwriters Laboratories
R2453
TAS 107 (ASTM D 3161)
10/11/10
Underwriters Laboratories
03NK04954
TAS 107 (ASTM D 3161)
03/07/03
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 913-72 of the Florida Administrative Code.
INSTALLATION
1. Shingles shall be installed in compliance with Roofing Application Standard RAS 115.
2. Flashing shall be in accordance with Roofing Application Standard RAS 115
3. The manufacturer shall provide clearly written application instructions.
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.
p NOA No.: 10-1015.01
MIAMI DADE COUNTY m - Expiration Date: 02/03/16
Approval Date: 02/03/11
Page 3 of 4
FIRST COU
DETAIL A
,,—EDGE OF ROOF
/
OWENS CORNING OAKRIDGE
11" -
DETAIL B
OWENS CORNING OAKRIDGE
WITH CONTINUOUS OFF DASHED SEALANT
39 3/8" -
211 2"
5 5/8" EXPOSURE
END OF THIS ACCFPTANCE
NOA No.: 10-1015.01
CMM I DARE CouNTY Expiration Date: 02/03/16
Approval Date: 02/03/11
Page 4 of 4
Property Appraiser - St.Lucie County FL
Page 1 of 1
Hifya Ayaz Record: 1 of 1
Property Identification
Site Address: 3201 RIVER DR
Sec/Town/Range: 30 :35S :40E
Map ID: 24/30N
Zoning: RS-3
PROPERTY RECORD CARD
<<Prev Next» Spec.Assmnt Taxes Exemptions Permits Home Print
,��,UCIECO
ParcellD: �243:0-5=02-0064-0004
Account #:
Land Use: SF Res Q�
City/Cnty: St Lucie County
Ownership and Mailing
Legal Description
Owner:
Hulya Ayaz
RIVER OAK ESTATES LOT 64 (0.36 AC) (OR 1291-1612: 1618-2817)
Address:
3201 River Dr
Fort Pierce FL
34982
Sales Information
Assessment 2011 TRIM
Total Land and Building
Date
Price Code
Deed
Book/Page
2011 TRIM: 104800
Land Value: 24800 Acres: 0.36
11/25/2002
44000 01
QC
1618 / 2817
Assessed: 104800
Building ValUe 80000
3/31/2000
110000 00
WD
1291 / 1612
Ag.Credit: 0
Finished Area 2362 SgFt
3/5/1998
100 01
QC
1135 / 2515
Exempt: 50000
9/1 /1986
110000 00
CV
0515 / 2897
Taxable: 54800
10/1/1977
0 01
CV
0276 / 1991
Taxes: 1342.65
12/1/1975
60000 00
CV
0247 / 1034
BUILDING INFORMATION
Exterior Features
View:
RoofCover:
SD - Dim Shingle
RoofStruct:
HP - Hip
ExtType:
HC - HC
YearBlt:
1974
Frame:
Grade:
C - C
EffYrBlt:
1977
PrimeWall:
BW - Brk/Wd Frame
StoryHght:
0010 - 1 Story
No.Units:
1
SecWall:
Interior Features
BedRooms:
3
Electric:
MX - MAXIMUM
PrmintWall:
DW - Drywall
FullBath:
3
HeatType
FHA - FrcdHotAir
AvgHUFI:
STD
1/2Bath:
0
HeatFuel:
ELEC - Electric
Prm.Flors:
CU - Carpet
%A/C:
100
%Heated:
100
%Sprinkled:
0
Special Features and Yard Items
Land Information
Type
Y/S Qty.
Units Qual. Cond. YrBlt.
No. Land Use
Type
Measure Depth
3CFT - 3CFT
S 2 0000000001
AV AV 1977
1 0100-SF Res
260 -Front Ft
125 125
SDSF - SITE DEV S-F Y 1 1 AV AV 2001
THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED
http://www.paslc.org/prc.asp?prctid=243050200640004 10/20/2011