Community Development Department
Building Construction Division
18400 Murdock Circle | Port Charlotte FL 33948
Building Phone: 941.743.1201 | Building Fax: 941.764.4907
Zoning Phone: 941.743.1964 | Zoning Fax: 941.743.1598
BuildingConstruction@CharlotteCountyFL.gov
CharlotteCountyFL.gov
Application Date
Permit Number
For Office Use Only
20
CSR Initials
APPLICATION FOR ROOF MODIFICATION PERMIT
Description of work to be done:
Address:
Building No.:
Unit No.: Parcel ID:
Construction Cost :
Florida Building Code 7th Edition (2020)
Job Site Details
11/2020 jg
Owner Information
Name:
Phone No. :
Email:
Underlayment Product Approval :
Roof Covering Material:
Contractor Information
Name:
Contractor's License No.:
Address:
Phone No. :
Email:
Fax No.:
Number & Street
Type:(St., Dr., Pkwy., Blvd., etc.) City State Zip Code
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 issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction.
Owners Affidavit: I hereby certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE FIRST INSPECTION.
IF YOU INTENT TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE
OF COMMENCEMENT.
NOTICE: In addition to the requirement of this permit, there may be additional restrictions applicable to this property that may be found in the public
records of this County, and there may be additional permits required from other governmental entities such as water management districts, state, or
federal agencies.
Under penalties of perjury I declare that I have read the foregoing document and that facts stated are true, correct and in compliance with the
applicable regulations.
F.S.92.525
(Owner's signature only if owner is acting as contractor. **An Owner-Builder Disclosure Statement will be required)
NOTICE: Permit is void if construction is not started within 180 days or does not receive an approved inspection within 180 days from date of issue. An approved
inspection will extend the permit for an additional 180 days. Starting work prior to issuance of a permit may result in a penalty fee of up to four times the permit fee.
Roof Replacement
Address:
Number & Street
Type:(St., Dr., Pkwy., Blvd., etc.) City State Zip Code
Number & Street
Type:(St., Dr., Pkwy., Blvd., etc.) City State Zip Code
Contractor/Owner Builder Signature:
Date:
Print Name:
Percentage to replace:
Year Building Built :
# of Squares:
Roof Covering Product Approval:
Roof Re-Cover
Roof Repair
Mean Roof Height :
Roof Slope: Current Building Use:
click to sign
signature
click to edit
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