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�v INDIAN RIVER COUNTY BUILDING DEPARTMENT oz OR%�P• Applicant's Affirmation 1 affirm that I have verified that the roof components marked on roof summary pages are designed to be installed in coniunction with each other and as such meet all Miami -Dade NOA, Florida Product Approval and code requirements as a single component. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit, and that all work will be performed to meet the standards of all laws regulating construction, insurance, and worker's compensation. Properties on which earth spills or other debris falls shall be cleaned immediately. All streets, sidewalks, and curbs damaged due to this construction shall be repaired to the satisfaction of the engineering department prior to the issuance of certificate of completion. IN APPLYING FOR THIS PERMIT, I HEREBY ATTEST THAT I HAVE THE KNOWLEDGE AND UNDERSTANDING OF ALL THAT IS REQUIRED BY THE FLORIDA BUILDING CODE AND ALL LAWS AND REGULATIONS PERTAINING TO PERFORMING AND COMPLETING THIS TYPE OF WORK. Owner's Affidavit: 1 certify that all theregoing information is accurate and that all applicab a ws regu ting construction and zoning. work will be done in compliance with all Owner/ g ntgnature Contractor Signature IQr�,�1 �6• SzPytKq State of Florida, County of State of Florida, County of The foregoing instrument was acknowledge before me I The foregoing instrument was acknowledged before me day of KIAQU' 20,_011/__ )_1 By who is personally known or ❑produced identification Type of ID produced Printed Name of Notary ►12 Signature of Nota Notary Seal titi""'t;, LUANNECLARK CommIu1m#G0244341 AE PIms Navem6er 6,2022 %• ,o;; }' • 8an4ad Thu Troy fxfn lnwrm day of By 20 who is ❑personally known or ❑produced identification Type of ID produced Printed Name of Notary Signature of Notary Notary Seal 'Value: show proof of insured value of residential structure or a copy of the ad -valorem tax value, 2Commercial Roofs: Provide a roof plan with components and cladding pressures, location and size of applicable zones prepared by a Florida Licensed Engineer. A copy of the roofing material's Miami -Dade NOA or Florida Product Approval will be required with permit application. A Florida Licensed Engineer may need to data extrapolate the attachment requirements of the Product Approval to meet the components and cladding Pressures of the roof or calculate the moment connection for a tile roof system. 'Repairs: Provide a roof sketch (Page -9) showing location of the repair and % of the repair area to total roof area. •RESIDENTIAL ONLY: Roof Zone Wind Pressure sheet (see Pages 6-8 of this application) must be completed. 5RESIDENTIAUCOMMER61AL: Roof Recovering requires an inspection of the existing roof prior to work commencing. 6NOTE: ALL ROOF PERMITS REQUIRE A SKETCH TO BE SUBMITTED (SEE PAGE -9 OF THIS PERMIT PACKET) IRESIDENTIAUCOMMERICAL: If current roof covering is a lightweight system (shingle/metaUetc.) and roof covering is changing to a heavy system (tile), a Florida Licensed Design Professional must provide structural member/system verification for items such as wood or metal trusses, rafters, joists, etc. to ensure existing structural system is adequate for increased load. Page 4 of 9