1163 Beach Ave roof 2013CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
. . . . .
13-00002288
Date 3/08/13
Property Address
. . . . . .
1163 BEACH AVE
Application type description
ROOF PERMIT
Property Zoning .
. . . . . .
TO BE UPDATED
Application valuation . . . .
21000
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Application desc
REROOF
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Owner
Contractor
------------------------
ADAMS CHARLES P
------------------------
DUBO ROOFING
1163 BEACH AVE
P 0 BOX 10252
ATLANTIC BEACH
FL 322335727
FLEMING ISLAND
FL 32006
(904) 396-1889
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Permit
ROOF PERMIT
Additional desc .
.
Permit Fee . . .
. 155.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . .
. . 21000
Expiration Date .
. 9/04/13
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Other Fees . . .
. . . . . .
STATE DCA SURCHARGE
2.33
STATE DBPR SURCHARGE
2.33
----------------------------------------------------------------------------
Fee summary
Charged
Paid Credited
--------------------
Due
----------
-----------------
Permit Fee Total
----------
155.00
155.00 .00
.00
Plan Check Total
.00
.00 .00
.00
Other Fee Total
4.66
4.66 .00
.00
Grand Total
159.66
159.66 .00
.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
Permit No. — Tax Folio
State of Florida County of Duval
The undersigned hereby gives notice that improvement will be made to certain real property, and In accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. LEGAL DESCRIPTION OF PROERTY being improved: RE # 170272-0.0.0,- Parcel _ID#: 6 -116 -2S -29E.671
ATLANTIC BEACH _^
Address of property being improved: 1163 BEACH AVENUE, ATLANTIC BEACH, FLORIDA 32233
2. GENERAL DESCRIPTION OF IMPROVEMENT:_ re -roof shingle_to shingle _
3.
OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name: CHARLES OR SUSAN ADAMS _
Address: 1163 BEACH AVENUE ATLANTIC BEACH. FLORIDA 32233
Owner's interest in property: -FEESIMPLE-.,___-.,
..__--__
Fee Simple Titleholder (if other than owner)___
Address:
4. CONTRACTOR'S NAME: DUBO Roofing Co.
Address P.O. Box 10252 Fleming Island, Fl 32006 --_
Phone: (904) 396-1889 _ Email: _duboroofinaftubo.net
5. SURETY (if applicable, a copy of the payment bond is attached)
Name: —_- -_ ...
---------�--------- Doc # 2013060697, OR BK 16283 Page 1308,
AddressNumber Pages: 1
Phone No. _, _ _ Amount Recorded 03"08;2013 at 04:10 PM,
6. LENDER'S NAME: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
-- -- --- ----- -- COUNTY
Address RECORDING $10.00
Phone No.
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:
Name
Phone
Fax
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in
Section 713.13(1)(b), Florida Statutes.
Phone
No. --- _
9. Expiration date of Notice of Commencement (the expiration date will be one (1) year from the date of recording unless a
different date is
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA
SATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND
TO OBTAIN FINANCING, CONS LT �1TH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR-NQPCE OF COMMENEN
--------- - +
ure, or Owner's or Print Nam and signato 's Title/Office
er/Manager)
The foregoing i_l_l— �tnsttrume/nit was acknowledged before me this _-_C% day of, __M_o�__,...__.__ _ 20
by QQas
—home
(name of person) (type of authority,... eg. officer, trustee, attorney in fact)
for_-------------- -- - --- --- ------
(name of arty on behalf of wh m instr ent was executed) SUSAN D. LUDLAM
Notary ic - State of Florida
'v My Comm. Expires Apr 2, 2014
-Nf «OP:
Signature of Notary - State of Florida .;Fob f„°;�•'• Commission r DD r9620380
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1163 BEACH AVENUE�ATLANTIC BEACH FL 32233 _ Permit Number:
Legal Description 6 -1 16 -2S -29E.571 ATLANTIC BEACH _ Parcel # 170272-000_0
_ FToor Area o�--Sq.l+t. ` Sq.Ft
Valuation of Work $121,000.0ij Proposed Work heated/cooled 3396 non-heated/cooled_ 5134
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one):Commercial ✓ Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Aproval # _..-
For multiple produpr
cts use oTuct approval form
Describe in detail the type of work to be performed: REROOF SHINGLE TO SHINGLE
Pro a __Owner Information:
Name: CHARLES ADAMS� Address: 1163 BEACH AVENUE__
City ATLANTIC BEACH _ _____._—_ State FL_ Zip 32233--. Phone (904�54S-23S7�- _ ___._ _ __-__ _ _..___._
E -Mail or Fax #
Contractor Information:
Company Name: DUBO ROOFING CO Qualifying Agent: OTIS A DUNCAN JR_—._._._._
Address: P.O BXO10252__.________._City FLEMING ISLAND State FLORIDA Zip 32006
Office Phone (904 396-1889 Job Site/ Contact Number Fax #(904) 3%-1848
State Certification/Registration #CCC0582.16 ____-___
Architect Name & Phone
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address —
Bonding Company Name and Address —
Mortgage Lender Name and Address
Application is ere made to obtain a permit to do the work and installations as indicated !certify that no work or installation has commenced prior to the
issuance o%a permit and that all work will be per fornted to meet the standards of al! laws regulating construction in this jurisdiction. This permit becomes null
and void i%work is not commenced withfn six (bJ months, or if cnnslruction or work is,
or abandoned fur a period of six tS) months at any lime after
work is commenced. I understand that separate permitx mus[ he secured for Eltctrica/ WorAy Plambing, Signs, We//s, Poo/s, �urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc.
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 YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinan
type of work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give authority to viol ite n an
provisions of any other federal, state, or local taw regulating construction or the performance of construction. ,p
o q R
Signature of Owner _ Signature of Contractor _ _ _ t j 0
Print Name �nr\ti,�•�CXrn�^'�� �� Print Name Z
0
_....�........_..................... .__........._......_........._.._.. _ �__ _ _ __. CJ h�..:.._.D fir.... Ism .
Sworn to and subscribed before me
this Day of ft--- .20/3
Notary b i ,"+
Notary Public State of Florida
Linda P Vemil
`MY ' My Commission EE 112987
koi nog Expires 10/24/2015
Sworn to and subscribed before me z a I
this _(C_ Day of ����-a428�.>
Notary , u <c�` ' . 4
Revised 0 1. 26
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA
Project Name: A(70i)i-5 RFS lC1 e -,t ? ( (:—
Project Address: l c l3 '(rt Gi, A V 2 n ((,e- A f--Lh c. beach , �� L-2 23
Permit #
As required by Florida Statute 553.842 and Florida Administrative Code Rule 913-72, 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. 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
Category/Subcategory Manufacturer
Product Description Limitation of Use State # Local #
C. PAINEL 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 C, H
2.Underlayments G,1)r
3. Roofing fasteners j'7
r' , `�' r , �(� {� 130
,r -L
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 the adhesive
16. Spray applied polyurethane
roof
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