275 Sailfish Dr Building 2 PPI21-0008 Shingle, Mod Roof PRIVATE PROVIDER INSPECTIONS PERMIT NUMBER
PERMIT PPI21-0008
ISSUED: 12/15/2021
CITY OF ATLANTIC BEACH EXPIRES: 6/13/2022
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements 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 agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
PRIVATE PROVIDER Building#2: COMMERCIAL-
201 275 SAILFISH DR INSPECTIONS REROOF NON SHINGLE AND MODIFIED $23615.00
SHINGLE ROOF
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170579 0000 SALTAIR SEC 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
ELO RESTORATION, INC 3415 KORI ROAD JACKSONVLLE FL 32257
OWNER: ADDRESS: CITY: STATE: ZIP:
MARSHPOINT MULTI 2300 MARSH POINT RD STE 301 NEPTUNE BEACH FL 32266
FAMILY ONE
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 THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 BUILDING ROOF IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL
Notes:
a.The roof sheathing for all new construction must remain uncovered until the Roof Sheathing Inspection is approved.
b.All roofing projects require an In-Progress Inspection.
c.Sheathing installation and replacement guidelines per APA.
d. Underlayment must conform to FBC-R Table 905.1.1
e.Shingles must conform to ASTM D3161 G or H,or ASTM D7158 F
Issued Date: 12/15/2021 1 of 2
s'oLi-wry, PRIVATE PROVIDER INSPECTIONS PERMIT NUMBER
sA
� PPI21-0008
75 PERMIT ISSUED: 12/15/2021
on ,/CITY OF ATLANTIC BEACH EXPIRES: 6/13/2022
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ADMINISTRATIVE FEE 455-0000-322-1000 0 $35.00
BUILDING PERMIT 455-0000-322-1000 0 $127.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $81.25
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.66
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.44
TOTAL:$249.85
Issued Date: 12/15/2021 2 of 2
j/ _ I INSPECTIONS REQUIRED FOR BUILDING PERMITS (PRIVATE PROVIDER)
-% +�• I To verify compliance with building codes,inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
Power Pole Final Plumbing
Silt Fence Final Electrical
Piers/Stem Walls Final HVAC
Underground Plumbing CC Final
Underground Electric Final Building*
Foundation/Footing •For new living space:When all construction work including electrical,plumbing,
mechanical,exterior finish,grading,required paving and londscoping is complete
Slab** and the building is ready for occupancy,but before being occupied
••FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION Swimming Pool Steel
Retaining Wall Footing Swimming Pool Safety
Driveway Electrical Grounding&Bonding
2. Sewer(Building Dept) Swimming Pool Final (Bldg)
Sewer Tap(Utilities Dept) 8. Swimming Pool Final (PW)
Additional inspections may apply to your project if your project
Rough Electric* contains these elements: _
Rough Plumbing/Top Out* Formed Columns/Beams*
Rough Mechanical* Masonry Cell Fill
•When all rough electric,plumbing,mechanical are complete but before any work is •When forms and reinforcing steel,anchor bolts,sleeves and inserts,and all
covered up. electrical,plumbing and mechanical work is in place,but before concrete is poured.
House Wrap Structural Steel*
Wall Sheathing •When all structural steel members ore in place and all connections are complete,
--- ----- -- but before such work is covered or concealed.
Roof Sheathing
OTHER:
Tie-down Framing Connections
OTHER:
Rough Framing
_ OTHER:
3. Roofing In Progress
OTHER:
4 Window/Door In-Progress
OTHER:
Insulation Ceiling - -
Insulation Wall ROOFING PERMIT/REPLACEMENT
Exterior Lath -- -
Permit Type
5. Stucco Scratch Coat
6 Exterior Siding In-Progress PPI 21-0008
Brick Flashing&Ties Permit No.
7. Early Power 201-275 SAILFISH DR., A.B.
Gas Rough Job Address
Gas Final*
•When all gas piping is complete and wallboard is installed but before gas is
ELE RESTORATION, LLC
attached to any appliance.All outlets must be copped and pipe pressurized of o
Contractor
minimum of 15 lbs.
POST THIS CARD WITH PERMITS AND PERMIT
Building Department Public Works/Utilities Fire Department DOCUMENTATION IN FRONT OF BUILDING
Phone:904-247-5826 Phone:904-247-5834 Phone:904-630-4789
Fax:904-247-5845 Fax:904-247-5843 Fax:904-630-4203 I N S P L C T I O N L I N EE: 904 247 5 814
MUST CALL BY 4PM PREVIOUS DAY FOR NEXT DAY INSPECTION
Construction Hours per City Code,7am-7pm Weekdays.Sam-7prn Weekends
JOB COP" REVIEWED FOR CODE COMPLIANCE.
/J ;f�':''r,:.. Building Permit Application
,:�+{ '", ; City of Atlantic Beach Building Department REVIEWED
J �/ 800 Seminole Road, Atlantic Beach, FL 32233 By Mike Jones at 3:18 pm, Dec 10, 2021
,i1_.c
Phone: (9 4) 247-5826 Email: Buildi,:-De• acoab.us
�f�j
my', jr, ,i PPI21-0008
Job Address: ��"2'Irl/`; DVS-Off" 'r /ZpPermit Number:
10-8 17.25-29E 2 OSALTAI SEC(LOTS 580,587 TO 592,NW /2 STCI.OSEDBY U/R Il [IRDS 65-86-1..65.89.20,31 1 ROYAL PALMS UNIT 02A �/� 0 ��
Legal Description LOT I7BLK27PTSEC 38.2S-29ERECDO/019660168 REN '`}
Valuation of Work(Replacement Cost)$2i 6 IS. '? eated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door 3�e 2i.0or,---
• Use of existing/proposed structure(s): 4Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: es ONo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) $4No
Describe in detail the type of work to be performed: -� / 1/ ,
//i4)/ . g- , / / / i//4- , / , /5
Florida Produ pruval#(
lf J 1 / / _for mult..le products use product approval form
Property Owner Information MO el-. LC
Name hl+►pxte 4aorwr I U L-r - CA-U`+z c-� Address ..230(r) IutAl�� 1 4(- fo 7 woo 30(
City Oe -40) 3G(} State C(..- Zip ., -paA Phone 'OCf -5r53-ggO1
E-Mail "St-‘40 $v4.4i ps-rt, ,er. _ Gif)skA -
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor Informati_• // I
Name of Company I,/ A /. %,., . , Qualif ing A;,,nt L;,° 'L Ct 04 S
Address '//S ,/-j City I, ,,'ir..�-I�# State . Zip-3'225R—
Office Phone CM l va0, ` e/VI, Job Site Cont/t Number •D' .if '"fState Certificatn/Registration#CCC k '5t SdsS E-Mail_ lot• 4.? et°C�kvct� 04\.•Cr''\
Architect Name&Phone# v
Engineer's Name& Phone#
Workers Compensation Insurer" j UQd *'-L k JCLL OR Exempt❑ Expiration Date (o
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 the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS,POOLS,FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements 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 agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I 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 FORTJMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NO_TIC_ E OF COMMENCEMENT. �.
,\
(Signature 0f Qwner or Agent) (Signature of Contractor) 2
gned and sworn to(or affirmed)befor- me this Il day of Signed and swornto(or affirmed)before me this day of
_ , Oat j9e(Ak_ 4 cels _ 9g I4k or
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4.1. '9imp -ye y el
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= ,s► COMMISSION#GG233893 o�,0PU.9, JENNIFER I.ORTIZ
x ,.{ :*E r r ,:s Commission#HH 104049
1rii II•Iil\I:I.o:,�I1( �;t, ` EXPIRES: Jul 1, 2022 IV_ knowrrOR , :;, s,
July Vim— N ! •. Expires March 14,2025
' H'''ru:':a Iul nn'II.�h! •• '�`� Bondedm !P""15""('''''''''''
'r1(151:1(1 1(15 r�I Iicanon ', ��
hrl vlj5" flI NMI Notary Fp,l o OondedThuBudgelNotarySuvtas
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OFFICE COPY Use of Private Provider PPI21-0008
ROOF
Project Name: %� �/11 04,41/1,41,0 1
Parcel Tax ID: n-QS 1 - 00 REVIEWED
By Mike Jones at 3:20 pm, Dec 10, 2021
Services to be provided: Plans Review
Inspections
Note: If the notice applies to either private plan review or private inspection services the Building
Official may require, at his or her discretion, the private provider be used for both services pursuant to
Section 553.791(2) Florida Statute.
I � S
owner, a
arm I or my contractor have entered into a contract with the Private Provider indicated below to the fee
conduct the services indicated above.
Private Provider Firm: Legacy Engineering, Inc.
Private Provider: John Ellis, HI
Address:
6424 Beach Blvd.Jacksonville, FL 32216
Telephone: 904-721-1100
Fax:
Email Address(Optional): PPldept@legacyengineering.com
Florida License, Registration or Certificate#: PE 81349
•
I have elected to use one or more private providers to provide building code plans review and/or inspection
services on the building that is the subject of the enclosed permit application,as authorized by s. 553.791,Florida
Statutes. I understand that the local building official may not review the plans submitted or perform the required
building inspections to determine compliance with the applicable codes, except to the extent specified in said law.
Instead,plans review and/or required building inspections will be performed by licensed or certified personnel
identified in the application. The law requires minimum insurance requirements for such personnel,but I
understand that I may require more insurance to protect my interests. By executing this form,I acknowledge that I
have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance
and am satisfied that my interests are adequately protected. I agree to indemnify,defend,and hold harmless the
local government,the local building official,and their building code enforcement personnel from any and all
claims arising from my use of these licensed or certified personnel to perform building code inspection services
with respect to the building that is the subject of the enclosed permit application.
I understand the Building Official retains authority to review plans, make required inspections, and enforce the
applicable codes within his or her charge pursuant to the standards established by s. 553.791,Florida Statutes. If I
make any changes to the listed private providers or the services to be provided by those private providers, I shall,
within 1 business day after any change, update this notice to reflect such changes.The building plans review
and/or inspection services provided by the private provider is limited to building code compliance and does not
include review for fire code, land use, environmental or other codes.
--- •vttowing attachments are provided as required: OFFICE COPY
1. Qualification statements and/or resumes of the private provider and all duly authorized representatives.
2. Proof of insurance for professional and comprehensive liability in the amount of$l million per
occurrence relating to all services performed as a private provider, including tail coverage for a minimum
of 5 years subsequent to the performance of building code inspection services.
Individual Corporation
Partnership
Print Corporation Name Print Partnership Name
,..iiiiimm......
PW—+____ _ By: By:
(signature)
Print (signature)
Print Prim
Name:�Qrk Name:
Address: Name:
Its: Its:
Address: Address:
Telephone
No.: 44(41s-3-(v8t�t —
Telephone Telephone
No. No.:
Please use appropriate notary block.
STATE OF ' `fir
COUNTY OF�Uk,V6.1,
Individual Corporation Partnership
fore me, this I I day of Before me,this day of Before me,this day
,20 at,personally ,20_ of ,20_
appeared _. f) ,.,---Te.-k-Oz. personally appeared personally appeared
who executed the foregoing instrument, of
and acknowledged before me that same a partner/agent on behalf of
was executed for the purposes therein corporation,on
expressed. behalf of the state corporation,who a partnership,who executed the
executed the foregoing instrument and foregoing instrument and
acknowledged before me that same was acknowledged before me that same
executed for the purposes therein was executed for the purposes therein
expressed. expressed.
Personally known r' . Produced i ratification Type of identification produced
i
Signature of Notary d` ,A.rt s
`�.� Print Name vt f� 1 I G`—
/
Notary Public: NOTA' ` TAMP BELOW
My commission expires:3;1) 11 9-02-2--
0%.
-02-Z
'r% Virginia Wetzel
,.�COMMISSION t 66233893
%; f'' EXPIRES: July 1, 2022
„4;,«k . Bonded'Nu Aaron Notary
Doc # 2021314987 , OR BK 20032 Page 880, Number Pages : 1 ,
Recorded 11/29/2021 03:27 PM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
JOB COPi
Permit No PPI21-0008
Tax Parcel Number
\.
17057 9-00 1 0 NOTICr Or COPIIMENCEuENT
• State of Florida County of Duval
The UNDERSIGNED hereby gives notice that improvement will be made to certain real
property,and fn c:ordanc a with Cbaoter 713,Florida Statulea,the following Information
provided kt thio Notice of Commencement
1. Description of Property.goo iluioeion awe popsy,eM stent*Mtn a avdidrk)
10-8 17-2S-29E 2.0 SALTAIR SEC 1 LOTS 580.587 TO 592,NW 1/2 ST CLOSED BY U/R BCH ORDS 65-86-13,
65-89-20.5 31.1 ROYAL PALMS UNIT 02A LOT 17 BLK 27 PT SEC 38-2S-29E RECD O/R 19660-168
2300 MARSH POINT NEPTUNE BEACH, FL 32266
2, OansuI dear 1ptlon of knprovemeot
Re-Roof
• 3. Owner information cc Lessee InformaDen U the Lessee contracted(orihe improvement:
a Name endaddress MARSHPOINT MULTI FAMILY ONE LLC
2300 MARSH POINT NEPTUNE BEACH, FL 32266
b. IotenstIn property Ownet
.
c, Name end address of tee simple fdtehofder (If other than owner)
4, a. Contractor:Mame and address Elo Restoration INC
3415 Kori Rd Jacksonville FL, 32257
b. Contractor's phone number 904-528-0188
5. Surety(if applicable,a copy of the payment bond Is attached):
a. Name and address
b. Phone number
c. Amount of bond S .00
E. a. Lender:Name and address
b. Lender's 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:
a. &ma and address
b. Phone numbers of designated persona:
S. a.In addition b himself,Owner designates of to receive a copy
of the Lie twee Notice as provided in Section 71113(1)0b),Florida Statutes
b. Phone number
9. Expiration dab of Nodal of Commencement(the expiration date Is 1 year from the date of recording epics*a different data
Is epeoffied)
WARNING TO OWNI3t ANY PAYMENTS MADE ERAPTER Tme.ExPIItATION OP THE NOTICE OP COVM,NCEINENT A.RE CONSIDERED
rdPROPERPATEENTSUh'D CHAPTER I,SECTION T13.13,FLORIDA STATd7E5,AND CAN RESULT INYOUR PAYING TWICE FOR
HPROVEllENTS T A . OF CONFIENCENCNT td18T BE RECORDED AND POSTED ON THE JOB SITE DEFAME THE MIT
INSPECT.., a •• ''TO 0'• • NJO,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORX OR RECORDING
Signature*Nemo or -. a.. • , �,. .•OfficedDtredodPartxerfllanager(saefontaming
Signato •1 O'A( 4
State of M C� ,County of \-...)41.-Y
.••.ent nes acknow-•gad b ore n by teems of L el Fennell or f„'crane actatft>Boo en iib (r ei
.ur.'•• 3, r • e, • . r whets(4peltocalyknown to meor(„)who
P
L1dIJ
asIdeoenrllon. •
rel 0—)%ga,y ,,,;• ;� inia Wetzel Stapp e et P Naof Nobry PvbOo
+ ;'t COM !ZION/GG233893
/
1 wncu 1 .
��..• I-EXPIRES:July 1, 2022
'�'r rirrm 8olllied Ttxu ural Notary
JOB COPY REVIEWED
4'in, By Mike Jones at 3:21 pm, Dec 10, 2021
'ver PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
uit S?
*Project Address: SG i�, S1n Q . 6 Permit#: PPI21-0008
*Owner/Project Name: ��tl� " S Sc , (
As required by Florida Statute 553.842 and Florida Administrative Code Rule 61G20-3, please provide the information and product approval number(s)
for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact
your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide
product approval may be obtained at:www.floridabuilding.org.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
1.Swinging
2.Sliding
3.Sectional 1
4.Garage Roll-Up
5.Automatic
6. Other
B.WINDOWS
1.Single hung
2. Horizontal slider
3.Casement
------ ----
4. Double hung
5. Fixed V) 1
6.Awning
7. Pass-through
8. Projected
9. Mullion
10.Wind breaker
11. Dual action
12.Other
Page 1 of 4 Updated 06/21/21
JOB COPY
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
C.PANEL WALL
1.Siding
2.Soffits
3. EIFS
4.Storefronts
5.Curtain walls 1K
6.Wall louvers
7.Glass block
8. Membrane
9.Greenhouse
10.Synthetic stucco
11.Other
D.ROOFING PRODUCTS
1.Asphalt shingles pave nS Cotr►t^1 QCA/L:i �_ \O(4 - /l(P
2. Underlayments '1-0)2,5t 51 v11 A•e C- ICD_Ake. "Qv a-
3. Roofing fasteners
4. Nonstructural metal
roof
5. Built-up roofing
6. Modified bitumen Ce{'kr-4ke�
7.Single ply roofing
8. Roofing tiles
9. Roofing insulation
10.Waterproofing
11.Wood shingles/shakes
12. Roofing slate
13. Liquid applied roofing
14.Cement-adhesive
coats
15.Roof tile adhesive _
16.Spray applied
polyurethane roof
17.Other
Page 2 of 4 Updated 06/21/21
lop (''QPY
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
E.SHUTTERS
1.Accordion
2. Bahama
3.Storm panels
Olk
4.Colonial
5. Roll-up A \ '
6.Equipment
7.Other
F.STRUCTURAL
COMPONENTS
1.Wood
connector/anchor
2.Truss plates
3. Engineered lumber
4. Railing
5.Coolers-freezers
6.Concrete admixtures
7. Material
8. Insulation forms
9. Plastics
10. Deck-roof
11.Wall
12.Sheds
13.Other
G.SKYLIGHTS
1.Skylight Ke► .Q/ Cuf b r`pu`AkQ 1Stcl • I
2.Other
H. NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
Page 3 of 4 Updated 06/21/21
JOB COPY
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the
ones listed in this document must be approved by the Building Official.
*Contractor Name(Print Name):9CrQ`6.-- l\\i c,yn5 *Contractor Signature:
*Company Name: 61/C) (2-lecy\ u6"-C‘ bv—\
*Mailing Address: 31"(k J r% �1�-•
*City: �C £SC• \ ►L e- *State: � *Zip Code:
*Telephone Number: CI OM S'..2.1—tLB? *E-mail Address: 3')C-EleZ e 1c)rlAd -c---V,e9vt• cam
Cell Phone Number: C1 + 'C J—k(.0 O L Fax Number:
Page 4 of 4 Updated 06/21/21
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