Fillable Application for Roofing Permit Highlands County, Florida (Revize)

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Application for Roofing Permit Highlands County, Florida (Revize)

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Application for Roofing Permit
Highlands County, Florida
Owner__________________________________________ ______________________________________
_________________________________________ Address _______________________________________________
City_____________________________________________ _
_________________________________________________
Phone___________________________________________ _______________________________________________
Roofing Contractor
Ad
dress
City
Phone
Legal Description Of Property:
Strap: C-____-____-____-_____-_______-_______ ________
Map Number Subdivision_______________
Lot _______ Block
_______
Address:____________________________ Legal Description________________________________________ Unit/Sec______
I. New Construction_______ Repairs: ______ Roof Over (Mobile Home only): ______ Remove Roofing & Replace: ____________
Value of Work [Contract Price] $_______________
Permit Fee
Certificate of Completion
State Surcharge
Total:
$__________________
$__________________
$___________________
$___________________
II. Type Of Roof Covering
1. Flat
-Build Up______ 2. Wood Shingles/Shakes _______ 3. Asphalt/Fiberglass Shingles _______ 4. Tile_______
5. Slate______
6. Other ________ 7. Sheathing Solid________ Spaced______
III. Pitch of R
oof ______/12 Number of Squares____________ Underlayment______________________
Size of F
astenings-Nails___________ Staples_________
IV. Flashing:
V
alley__________ Rakes___________ Copings__________ Eaves Drip___________ Gravel Stop______________
V. Is Removal of A
ny Hazardous Materials A Part Of This Project? _______________________
I hereby certify that I understand all the items listed above are part of the conditions of t
he permit. Minor repairs may be performed but all structural repairs shall
be performed by a Contractor licensed for the work involved.
The inspections shall follow requirements listed in the Florida Building Code.
1. Sheathing
2. Dry-In
3. FInal
_________________________________________ _________________________
Signature Of Owner Or Roofer Date
_________________________ ________________________________________
State Number
County Number
I do hereby certify that any work subcontracted on this job, are duly certified and licensed contractors, and hold a Certificate Of Competency Card in
Highlands County.
Revised 11-2019
No
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Application for Roofing Permit Highlands County, Florida (Revize)

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Completed 11 April 2022

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