HomeMy WebLinkAboutPRODUCT APPROVALALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:6(.
f , Permit Number:
n �
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 Residential i
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED'IMPROVEMENTLOCATION:
Address: __ (Sn N I /-i l/ r -17)r/11#- FOP -r 54SEL
Legal Description: SlI.ULrL LAL_E fP�ZIC S(D B( -K 3 L otS I
GZ I90'7_ f00,9 2.s -
1453
Property Tax ID #: 2L27- 701 - onkZ- DOCS- cj
Lot No.
Site Plan Name:
Block No. 5
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILEDDESCRIPTION OF WORK:
n
dC�MOt%e i� PULP (_C 57fjo,)66rLc F RCMDLfc Z_Lprgee(
Dr
i €_h J efL OF 30--ti�_ I CLUND6LLF�M Elm i -
,r.nS7A-L,_ 77�-rAL�-o
30 qt AV -Ca.
CONSTRUCTION INFORMATION:
A0artional worl< to be Dertormeun ert ispermit - c ec a a appy:
HVAC Gas Tanl< ❑Gas Piping _Shutters
11
Windows/Doors
Electric 0 Plumbing Sprinklers E Generator
1 Roof
Total Sq. Ft of Construction: �S 1t. o. First Floor.
Cost of Construction: $ ss�"�3 Utilities: DSewer Septic
Building Height:
, llenfn,rn ie rrn4-r :
�
Name kICAAd' 7 (18E6�Lt t
Address: i`], O.td nege4s ( (L
City: F A`s i /State:
Zip Code: Jfj q(oq Fax: ( 7 i -
Phone No. 5b I. 339 - (,�'E) (�
E -Mail 9sePi(kgp 8,R✓%I.k)F--,
Fill in fee simple Title Holder an next page (if different
from the Owner listed above)
_LUN I KACI UR:
Name: /'- 0—l", taellL
Company: I�O7fl�nf ( (GAG
Address: 2121 5tk) 0_0JPrfk1_L F"We
City: F6 [ Stater
Zip Code: 5th -Cts 3 Fax: /72) 344 -
Phone No. 172- 344 e E� id i
E -Mail: UC JrJc_&ga oy4' `{.OJ�'i
State or CoL/pty License: & (?(; - C 060 Z4-; I
If value os construction is $2500 or more, a RECORDED Notice or -Commencement is required.
Not App
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: _ Phone:
_ Not Applicable
iKIV1A I IVIN:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: j
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: %
Address:
Zip: Phone:
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 or 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 your Notice of Commencement_
of Owner/ Lessee/Agent
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF Sfir AJ -i- COUNTYOF `7f�ltl r iJt I�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1(� day of tjat? _,� 20 L by this day of maga Ef 20 / (, by
(Name of person acknowledging) (Name of person acknowledging )
of Notary Public- State of Florida )
Tyne of Id jj.t#'� .,K� *YbVtA CO
lf" r My Commission E� Ip
o _'F mrvey 27, 2 N
Revised 07/15/2014
Personally Known ✓ OR Produced Identification
Tyne of Identifiratin- PrnrLirerl
Commission No.
Commission V FF 955374
January 27
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
E
Product Approval Method Method 1 Option A
Date Submitted 09/17/2015
Date Validated 10/06/2015
Date Pending FBC Approval
Date Approved 10/09/2015
Products
del,
Description
mber or
me
e Glass-
A three tab asphalt shingle.
l
7rovedfor
e
Certification Agency Certificate
for use
FL1956 R12 C CAC FLi956 R11 C CAC Tamko Sery Com FL 1956 2015 odf
o
FL1956 R12 C CAC UL certification 10-11-12 odf
for use
Quality Assurance Contract Expiration Date
outside HVHZ:Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 II Glass Seal Elite Glass Seal aoo inst odf
Design
Verified By: Robert Nieminen 59166
Pressure: N/A
Created by Independent Third Party: No
Other: Asphalt
Evaluation Reports
shingles shall be
Created by Independent Third Party:
used only on roof
slopes of 2:12 ar
greater. Nails must
be used as the
method of
'. attachment.
1956.2 Glass -Seal
A three tab asphalt shingle.
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC FL1956 RI l C CAC Tamlco Se" Corr FL 1956 201 5odf
in HVHZ: No
FL1956 R12 C CAC UL certification 10-11-12 odf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 TI Glass Seal Elite Glass Seal aoD inst odf
Design
Verified By: Robert Nieminen PE 59166
Pressure: N/A
Created by Independent Third Party: No
Other: Asphalt
Evaluation Reports
shingles shall be
Created by Independent Third Party:
used only on roof
slopes of 2:12 or
ater. Nails must
usedas the
thod of
L
achment.
1956.3 Heritage
A dimensional asphalt shingle.
rtification Agency Certificate
pror
FLR12 C CAC FL1956 RI 1 C CAC Tamlco Seri Conf FL 1956 201 S.odf
V1956
R12 C CAC UL certification 10-11-1� odf
[i'lts7
pror
I
ality Assurance Contract Expiration Date
trid:/17/2018
pastallation
Instructions
ist
-LlY56 Rig II Heritaae D F 3 P anD in;t.ndf fl
n
FL1956 R12 IT Heritaae F aoo in<t.odr
re: N/A
FL1956 R12 It Heritage T aoo inst.odf
: Asphalt
Verified By: Robert J. M. Nieminen FL 59166
s shall be
Created by Independent Third Party: No
ly on roof
Lof
Evaluation Reports
of 2:12 or
Created by Independent Third Party:
. Nails must
as the
ofent.
1956.4 Heritage 30
A dimensional asphalt shingle.
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC FL1956 R11 C CAC Tambo Sery Cenf FL 1956 7015.DJf
in HVHZ: No
FL1956 R12 C CAC UL certification 10-11-1> odf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
F1-1956 R12 Ir heritag=_ 30 aDD in=t aoril 10 Ddf
Design
Pressure: N/A
FL1956 R12 ti heritage 30 aDD inst f aoril 10 odf
Verified By: Robert Nieminen PE 59166
Other: Asphalt
Created by Independent Third Party: No
shingles shall be
Evaluation Reports
used only on roof
Created by Independent Third Party:
es of 2:12 or
sloLbeused
r. Nails must
as the
d of
ment.
Heritage 50
A dimensional asphalt shingle.
of Use
Certification Agency Certificate
oved for use
HZ: No
FL1956 R12 C CAC FL1956 R11 C CAC Taml:o Sery Conf FL 1956 2015 odf
FL1956 R12 C CAC UL certification 10-11-12.Ddf
7HVHZ:No
oved for use
e HVHZ: Yes
Quality Assurance Contract Expiration Date
09/17/2018ct
Installation Instructions
ant: N/A
FL1956 R12 II heritage 50 ago inst acini 10.Ddf
n
FL1956 R12 II heritaoe 50 ago inst f aoril 10 odf
ure: N/A
Verified By: Robert Nieminen PE 59166
r: Asphalt
Created by Independent Third Party: No
s shall be
Evaluation Reports
useonly on roof
slopes of 2:12 or
Created by Independent Third Party:
greater. Nails must
be used as the
method of
attachment.
1956.6
Heritage
A dimensional asphalt shingle.
Premium
Limits of UseI
rtification Agency Certificate
Approved for u
FLR12 C CAC FL1956 R11 C CAC Tamm Sery Conf FL 1956 X015 odf
in HVHZ: No
FLR12 C CAC UL Certification 10-11-1 2.odf
Approved for uality
Assurance Contract Expiration Date
outside HVHZ:
/17/2018
Impact
stallation Instructions
Resistant: N/A1956
R12 lI Herhao=Premium C P ago inst.odf
Design
1956 R12 II Heritage Premium F aoo inst.Ddf
Pressure: N/A
FL1956 R12 It Heritage Premium T aoo instodf
Other: Asphalt
Verified By: Robert Nieminen 59166
shingles shall be
Created by Independent Third Party: No
used only on roof
Evaluation Reports
slopes of 2:12 or
Created by Independent Third Party:
greater. Nails must
be used as the
method of
attachment.
1956.7
Heritage
A heavy weight dimensional asphalt shingle.
Vintage
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC FL1956 RI C CAC Taml o Sery Conf FL 1956 2015 odf
in HVHZ: No
FLi956 R12 C CAC UL shingle =rir..odf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 it Heritage Vintage aoo instodf
Design I
Verified By: Robert J. M. Nieminen PE 59166
re: N/A
Created by Independent Third Party: No
Asphalt
Evaluation Reports
shall be
Created by Independent Third Party:
ly on roof
f 2:12 or
Lasthe
Nails must
as theofent.
1956.8
p and ridge shingles
Ed!
Limits of UseCertification
Agency Certificate
Approved for use
FL1956 RI C CAC FL1956 R11 C CAC Tamko S=ry Conf FL 1956 701 5Dd_f
in HVHZ: No
9L1956 R12 C CAC UL shingle matrix.Ddf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 RIZ II TAMKOrI Heritage(,) 12 x 12 Hip and Ridae AODlicatien Instructions.Dd
Design
Verified By: Robert J. M. Nieminen PE 59166
Pressure: N/A
Created by Independent Third Party: No
Other: Asphalt
Evaluation Reports
shingles shall be
Created by Independent Third Party:
used only on roof
slopes of 2:12 or
greater. Nails must
be used as the
method of
attachment.
1956.9
Heritage
A dimensional asphalt shingle.
Woodgate
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sery Conf FL 1956 2015 Ddf
in HVHZ: No
FL1956 R12 C CAC UL certification 10-11-12 Ddf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 11 Heritage Woodoate D ago inst Ddf
Design
FL1956 R12 II Heritage Woodoate F aoD inst odf
Pressure: N/A
Verified By: Robert Nieminen 59166
Other: Asphalt
Created by Independent Third Party: No
shingles shall be
Evaluation Reports
used only on roof
Created by Independent Third Party:
slopes of 2:12 or
greater. Nails must
be used as the
method of
attachment.
1956.10 Heritage XL
A dimensional asphalt shingle.
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC FL1956 R11 C CAC Tamko Sew Conf FL 1956 2015. df
in HVHZ: No
FL1956 R12 C CAC UL certification 10-11-12 odf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 II heritaae xl ago insL d aD l 10 df
Design
FL1956 R12 II heritaae A ago in -t f aD it 10 odf
Pressure: N/A
Verified By: Robert Nieminen PE 59166
Other: Asphalt
Created by Independent Third Party: No
shingles shall be
Evaluation Reports
used only on roof
Created by Independent Third Party:
slopes of 2:12 or
greater. Nails must
be used as the
method or
attachment.
1956.11
Hip and
Hip and ridge shingles
Ridge
Shingles
Limits of Use
Certification Agency Certificate
Approved for use
FL1956 R12 C CAC Fl RI l C CAC_Tamka, Sery Conf FL 1956 2015.Ddi
in HVHZ: No
FL1956 R12 C CAC UL certification 10-1I-:2.ndf
Approved for use
Quality Assurance Contract Expiration Date
outside HVHZ: Yes
09/17/2018
Impact
Installation Instructions
Resistant: N/A
FL1956 R12 II 12.25x12 Hip and Ridae Ddf
Design
FL1956 P.12 IT 12 x 12 HID Ridae Application Instruction, Ddf
Pressure; N/A
FL1956 R12 Ti 12-1-4;12 HioRidoe Sealant Dab Illustrations odf
Other: Hip and
FL1956 832 Ii 12x.12 HmDidg=_ Sealant Dab Ipustrations odf
Ridge shingles shall
Verified By: Robert Nieminen 59166
be used only on roof
Created by Independent Third Party: No
slopes of 2:12 or
Evaluation Reports
greater. Nails must
Created by Independent Third Party:
be used as the
method of
attachment.
—a_ _ __
Contact Us:: 19.0 North Monroe Street Tallahassee F 32399 Phone: 850-487-1824
The State of Honda is an AA/EEO employe'. Copvrioht 2007-2013 State of Florida :: Privacy Statement :: Acros milt, Statement :: 8erund Stet=ment
Under Florida law, email addresses arc public records. If you do not want your a -mail address released in response to a public -records request, do not
send electronic mall to this entity. Instead, contact the once by phone or by traditional mail. If you have any questions, please contact 850.487,1395.
°Pursuant to Section 455.275f 1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department
with an email address If they have one. The emalls provided may be used for official communication with the licensee. However email addresses are public
record. if you on not wish to supply a personal address, please pmvlde due Department with an email address which can be made available to the public.
To determine If you am a licensee under Chapter 455, F.S., please click hem
Product Approval Accepts:
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