467 INLND WAY RERF22-0144 E.Am\ REROOF SHINGLE PERMIT PERMIT NUMBER
# \�
' RERF22-0144
CITY OF ATLANTIC BEACH
"r. ISSUED: 6/21/2022
800 SEMINOLE ROAD
`Ji1�� ATLANTIC BEACH, FL 32233 EXPIRES: 12/18/2022
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:
467 INLAND WAY REROOF SHINGLE SHINGLE ROOF $32000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169463 1536 OCEAN WALK UNIT 04
COMPANY: ADDRESS: CITY: STATE: ZIP:
D & D ROOFING, LLC 2601 Percy RD JACKSONVILLE FL 32218
OWNER: ADDRESS: CITY: STATE: ZIP:
MERRILL KELLY B 467 INLAND WAY ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IIN
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $215.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.23
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.15
TOTAL:$220.38
Issued Date:6/21/2022 1 of 1
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
j '-)1800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 1161 XC�� (t�n�IG t7c[((,� 1�{, 3' Permit Number: l� ER)- Z Z—(1 4 4
Legal Description ift �� -ZS • ( j Oa/1)A ('• U1 r4- y CO-(Ifi 416 RE# 169(-16 -- 1534
Valuation of Work(Replacement Cost)$ 3Z0O0 Heated/Cooled SF 333 I{ Non-Heated/Cooled ti 3�1
• Class of Work: iNew ❑Addition DAlteration DRepair DMove DDemo OPool OWindow/Door
• Use of existing/proposed structure(s): DCommercial Residential
• If an existing structure,is a fire sprinkler system installed?: lAies I3Ne-
• Will tree(s)be removed in association with Proposed oroiect?DYes(must submit separate Tree emoval Per it) l'No
Describe in detail the type of work to be performed: I I
Florida Product Approval# F 1-WA 4 ' Cvt for multiple products use product approval form
Property Owner Information
Name DA v�A P Cff 1i I Address +"16-4 t(1/4"e14/9
City M.A./littx1. State Zip 32233 Phone ygoy- 315-42.311
E-Mail ---
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 1*0 ROtQh5 Qualifying Agent 17b t/If 3hlle, ,
Address 240) AM% City SgGK10ANIIt State ft• Zip 3'L2+li
Office Phone q09 SUL- Vita Job Site Contact Number W1- �/O -1304
State Certification/Registration# CCL 133 o2AZ. E-Mail CH(00-thpyir r GJpiAlt .(
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation Insurer OR Exempt,, Expiration Date 1/Oa)
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 FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING UR NOTIC MMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this 11 day of Signed and sworn to(or affirmed)before me this Z day of
2446 , ,by ZGOt , -2.&R . by .► v►fl ..• t
• t•'•n•tutu ery co Florida
Notary Pubtic State of Fiaida * Jacob L Stand
JaLStan ,CommissionHH 075373gt.
My Commission HH 075373 1 ,resai 29l202�Al Personally Known OR a / Expires 12/29/2024 *1 Personally Known OR Nye,�a��
[ ]Produced ldentificatio [ ]Produced Identification
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/ PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA(*REQUIRED)
*Project Address: ICR' "'r' td t (3ottd,. 4L 322 6) Permit#:
•Owner/Project Name: 00U to intia4
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 I Manufacturer Product Description I Limitation of Use State# Local#
A.EXTERIOR DOORS
1.Swinging
2.Sliding
3.Sectional
4.Garage Roll-Up
5.Automatic
6.Other
B.WINDOWS
1.Single hung
2.Horizontal slider
3.Casement
4.Double hung
5.Fixed
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
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Category/Subcategory Manufacturer Product Description Limitation of Use State# I Local#
C.PANEL WALL
1.Siding
2.Soffits
3.EIFS
4.Storefronts
5.Curtain walls
6.Wall louvers
7.Glass block
8.Membrane
9.Greenhouse
10.Synthetic stucco
11.Other /
D.ROOFING PRODUCTS
1.Asphalt shingles ()(LRnCACn►f1,, (4(4,t41S.it R•.. (.It 7Y .Rel
2.Underlayments Qy{�'n� Wif�lryj St
3.Roofing fasteners
4.Nonstructural metal
roof
5.Built-up roofing
6.Modified bitumen
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
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Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
E.SHUTTERS
1.Accordion
2.Bahama
3.Storm panels
4.Colonial
5.Roll-up
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
2.Other
H.NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
Pate 3 of 4 Updated 06/21/21
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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): Th40 1.1. Contractor Signature:
*Company Name:! AI&) LLC.
*Mailing Address: Z461VI C5led •
*City: �J✓Y/y *State: *Zip Code: 32
*Telephone Number: 9 0'1— so L-514 yV°Q `E-mail Address: din*lye* l: .5'44oa'Cat-
Cell
c .Cell Phone Number: Fax Number: �+
Page 4 of 4 Updated 06/21/21
Doc # 2022123105, OR BK 20268 Page 1671, Number Pages: 1,
Recorded 05/09/2022 11 :22 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of Florida
Tax Folio No.
County of Duval
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713
of the Florida Statutes,the following information is stated In this NOTICE OF COMM_ ENCEMENT.
Legal Description of property being improved: c-{Z -('.7s 5•i- 7 j -Z,(j G ,-e a 4-'\(
vn;'r Lo \ i E.I /2 ((.5e, C ) ftEcv) C/Pt 11`5'11 — \uhf,
Address of property being improved: KE r ,r,.r\•. \,:a {SCi(., r.�,C Tt,z c' F L
General description of improvements:Re-roof
Owner: —T2, f \ - LL _ Address: 14��L7p [t L d ) \j J
�yl.hY
Owner's interest in site of the improvement! AT6c, R.
Fee Simple Titleholder(if other than owner): )
Name:
Contractor: D&D Roofing,LLC
Address:2601 Percy Rd.Jacksonville,Fl 32218
Telephone No.:904-502-5488 Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:None
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served:Name:None
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided In Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:None
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a differ-. :. e is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNE• a
Sign d: Date'±>/1`1'i 7
Before e this . day of Ma in the County of Duval,State
Of Florida,has personally appeared\---y-4.1A t ((1 l\
Notary Public at Large,State oJl Florida, ount�/ . aL , ,^
Nly commission expires: (�) tot)1_4
/ �
Personally Known:
Produced Identification:L Py!)L Nogrynuewesa.dFforitl0
mfa w CHH 075577