42 EAST COAST DR PPRI21-0013 application3,800,000
PPRI21-0013
Form # 9B-3.053-2002-01
Notice to Building Official of
Use of Private Provider
Effective January 20, 2003
Project Name:
Parcel Tax ID:
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____________________________________________________________________________________, the fee
owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services
indicated above.
Private Provider Firm:
Private Provider:
Address:
Telephone: Fax:
Email Address (Optional):
Florida License, Registration or Certificate #:
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.
Page 1 of 2
Ahearn Mixed Use Building
169728-0000
X
Universal Engineering Sciences
5561 Florida Mining Blvd. S., Jacksonville, FL 32257
(904) 296-0757
C. Eric Pardee
jaxppi@universalengineering.com
904.296.0748
BU1699
City of Atlantic BeachCODES-ABC, INC.Reviewed for Code ComplianceFrederick “Art” BarthlowBU1701/PX115509/28/2021 "Codes-ABC, Inc. hereby certifies that these plans arein compliance with applicable codes, and have not beenchanged, altered, or modified by Codes-ABC, Inc."By Toni Gindlesperger at 9:56 am, Oct 12, 2021
Page 1 of 4 Updated 06/21/21
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
*Project Address: _________________________________________________________________________ Permit #: ___________________________
*Owner/Project Name: _______________________________________________________________________________________________________
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
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
42 East Coast Drive
GPS Holding Group LLC / Grand Ocean
Curries Hollow metal doors 11537.1
Oldcastle Alum. Storefront Doors 17692-R5
Page 2 of 4 Updated 06/21/21
Category/Subcategory Manufacturer Product Description Limitation of Use State # 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
2. Underlayments
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
Oldcastle Alum. Storefront FG-3000 17688-R3
Johns Manville TPO Single Ply Roofing 11475-R11
Page 3 of 4 Updated 06/21/21
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.
Page 4 of 4 Updated 06/21/21
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):_________________________________ *Contractor Signature: ___________________________________________
*Company Name: __________________________________________________________________________________________________________
*Mailing Address: __________________________________________________________________________________________________________
*City: _______________________________________________ *State: ______________________ *Zip Code: _______________________________
*Telephone Number: ___________________________________ *E-mail Address: _______________________________________________________
Cell Phone Number: _____________________________________ Fax Number: _________________________________________________________
Tim Young
Tim Young Construction, Inc.
10752 Deerwood Park Blvd. S., Suite 100
Jacksonville FL 32256
904-305-7055 tyoung@timyoungconstruction.com