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2328 BEACHCOMBER TRL 2015 ROOF �J `s CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD J X ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ROOF-998 Job Type: ROOF PERMIT Description: roof repair Estimated Value: $2,500.00 Issue Date: 4/29/2015 Expiration Date: 10/26/2015 PROPERTY ADDRESS: Address: 2328 BEACHCOMBER TR RE Number: 169463-0072 PROPERTY OWNER: Name: ALLIGOOD, CHARLES EDWARD Address: 2328 BEACHCOMBER TR GENERAL CONTRACTOR INFORMATION: Name: BOSCO BUILDING CONTRACTORS Address: 2158 MAYPORT RD QA TODD ALBERT BOSCO Phone• - - FEES: BUILDING PERMIT FEE $62.50 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $66.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. i BUILDING PERMIT APPLICATION D M CITY OF ATLANTIC BEACH �I 800 Seminole Road, Atlantic Beach, FL 32233 APR 29 Office(904)247-5826 Fax (904)247-5845 Job Address: 2328 Beachcomber Trl. Atlantic Beach, FL 32233 Permit Number: 7-1 Legal Description 42-1 08-2S-29E 09-2S29E Oceanwalk 104147 Parcel # Oceanwalk Unit 1 Lot 34 Floor Area of Sq.Ft. Sq.Pt Valuation of Work $ 2,500 Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Re air Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial si nti If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approval orm Describe in detail the type of work to be performed: Partial repair/re-roof on NW corner of house. Property Owner Information: Name: Charles Edward Alligood Address:2328 Beachcomber Trl City Atlantic Beach State FLZip 32233 Phone E-Mail or Fax#(Optional) Contractor Information: Company Name: Justin Larsen Construction,Inc. Qualifying Agent: Justin Larsen Address:4670 Hedge Hog St City Middleburg State FL Zip 32068 Office Phone 904-241-0320 Job Site/Contact Number 904-327-4311 Fax# 904-241-0326 State Certification/Registration# CCC 1329847 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 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 laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a eriod of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, 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 here b certify that I have read and examined this a plication and know the same to be true and correct. All provisions ojlaws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state,or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name r(/ q °/ Print Name ustin Larsen 1!__--. ._......---..-. .......].................... .................................................................................................. Sworn to and subscribed before me Sworn to and subscribed before me this Ze Day of 41of�4g_ this z Day of .20.5' Notary Public WILLIAM L.POPE Notary Public WILLIAM L.POPE Revised 01.26.10 Notary Public,State of Florida Notary Public,State of Florida My Comm.Expires Oct.19,2015 My Comm.Expires Oct.19,2(H5 Commission No.EE 128745 Commission No.EE 128745 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. State of Florida, County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of property(legal description of property and address if available): 2328 Beachcomber Trl.Atlantic Beach, FL 32233 -42-1 082S-29E 09 - 2S29E Oceanwalk 104147 Unit 1 Lot 34 2. General Description of improvements: Partial repair/re-roof to NW corner of house 3. Owner Information: a)Name and Address: Charles Edward Alligood 2328 Beachcomber Trl,Atlantic Beach, FL 32233 b) Interest in property: General c)Name and address of simple titleholder(if other than owner): 4. Contractor Information: a)Name and Address: Justin Larsen Construction, Inc. 4670 Hedge Hog St, Middleburg, FL 32068 b) Phone Number: 904-327-4311 5. Surety Information: a)Name and Address: Doc#2015096098,OR BK 17141 Page 425, b)Phone Number: Number Pages: 1Recorded 04/28,2015 at 02:13 PM. c)Amount of Bond: $ Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY 6. Lender Information: RECORDING$10.00 a)Name and Address: b) Phone Number: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13 (1)(a) 7, Florida Statutes: a)Name and Address: b)Phone Numbers of Designated Person: 8. In addition to himself/herself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13 (1)(b), Florida Statutes. a)Name and Address: b) Phone Number of person or entity designated by owner: 9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction and final payment to the contractor, but will be one (1)year from the date of recording unless a different date is specified: 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 STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. Signature of O- w4r or Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Naine&Title/Office � § b 2 3 Q > \ C = 2 0 / \ > A E 4 \ as .\ a _ t # # ct � ? 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Nieminen the Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 07/17/2017 Validated By John W. Knezevich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL10674 R9 COI 2014 01 COI Nieminen.Ddf Referenced Standard and Year (of Standard) mrd Year ASTM D3161, Class F 2006 ASTM D3462 2007 ASTM D7158, Class H 2007 Equivalence of Product Standards Certified By Sections from the Code https.//www.flonc1abuilding org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgtBNbEY5V%2boQT%2b6w7ahReglw99GOAnaSP6HOXhcDsyxEw%3d%3d 112 Florida Building Code Online Product Approval Method Method 1 Option D Date Submitted 02/28/2014 Date Validated 03/05/2014 Date Pending FBC Approval 03/05/2014 Date Approved 04/18/2014 Date Revised 04/22/2015 Summary of Products FL# Model,Number or Name Description 10674.1 Owens Corning Asphalt Roofing 3-tab, 4-tab, 5-tab, laminated, starter and hip&ridge Shingles and Starters shingles (Limits of Use Installation Instructions Approved for use in HVHZ: No FL10674 R9 II 2014 03 FINAL OC Asphalt Approved for use outside HVHZ: Yes Shingles FL10674-R9.pdf Impact Resistant: N/A Verified By: Robert 1. M. Nieminen PE - 59166 Design Pressure: N/A Created by Independent Third Party: Yes Other: Refer to ER, Section 5. Evaluation Reports FL10 74 R9 AE 2014 03 FINAL OC Asphalt Shingles FL10674-R9.pdf Created by Intdependent Third Party: Yes Rack n Contact Us :: 1940 North Monroe Street,Tallahassee FL 32399 Phone: 850-487-1824 The State of Flonda is an AA/EEO employer.Copyright 2007-2013 State of Florida. : Privacy Statement :: Accessibility Statement:: Refund Statement Under Flonda law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395. 'Pursuant to Section 455.275(1), Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455, F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do riot wish to supply a personal address, please provide the Department with an email address which can be made available to the public.To determine if you are a licensee under Chapter 455,F.S.,please click here . Product Approval Accepts: El 16-207 El M "writ% QW7911 https://www.floridaWIdirg.org/pr/pr_ppp_dtl.aspx?param=wGEVXQwtDgtBNbEY5Vp/n2boQT%2b6w7ahReglw99GOAnaSP6HOXhcDsyxEwp/o3d°/g3d 2/2 Florida Building Code Online '_18usiness & Professional Regulation �a f}pr,p �tpf Moore Log In ! uaer Rlymow Hot Topics Submit Surcharge Stats&Facts Publications FIC Stall BCIS Site Map Links Search Busines Professi I *USER: Product Approval Public User Regulation Product ADDroval Menu>Product or Application,Search>Aool i cation.List>Application Detail FL# FL11602-R2 Application Type Revision Code Version 2010 Application Status Approved Comments Archived Product Manufacturer InterWrap, Inc. Address/Phone/Email 32923 Mission Way Mission, NON-US 00000 (551) 574-2939 mtupas@interwrap.com Authorized Signature Eduardo Lozano elozano@interwrap.com Technical Representative Eduardo Lozano Address/Phone/Email 32923 Mission Way Mission, NON-US 00000 (778) 945-2891 elozano@interwrap.com Quality Assurance Representative Address/Phone/Email Category Roof i ng Subcategory Underlayments Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed Robert Nieminen the Evaluation Report Florida License PE-59166 Quality Assurance Entity Intertek Testing Services NA Inc.- ETL/Warnock Hersey Quality Assurance Contract Expiration Date 09/06/2015 Validated By John W. Knezevich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL11602 R2 COI Trinity ERD CI- Nieminen.Ddf Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Sections from the Code 1507.2.3 1507.2.4 1507.2.9.2 1507.3.3 1507.5.3 https:Nwww.floridabi ilding.org/pr/pr_app_Ml.aspx?param=wGEVXQwtDgsQFc5K%2fTrZeHYB7UCe5KMr8%o2fYe5dEpeyTPSmGoAPl6jA°/`3d°/`3d 112 Florida Building Code Online 1507.7.3 1507.8.3 1507.9.3 1507.9.5 1523.6.5.2.1 Product Approval Method Method 2 Option B Date Submitted 02/17/2012 Date Validated 04/18/2012 Date Pending FBC Approval 02/27/2012 Date Approved 04/23/2012 Summary of Products FL# Mo&K Nurnbar K Nanta Descrlptlon 11602.1 Titanium Roof Underlaymants Synthetic sheet-type roof lunderla menu Limits of Use 2nstaNation Instructions Approved for use in HVHZ: No FL11602 R2 II er021712FINAL INTERWRAP FL11602-R2.pdf Approved for use outside HVHZ:Yes Verified By: Robert Nieminen PE-59166 Impact Resistant: N/A Created by Independent Third Party: Yes Design Pressure: +N/A/-45 Evaluation Reports Other: 1.)The design pressure noted herein pertains to use FL11602_R2 AE er021712FINAL INTERWRAP FL11602-R2.pdf of a specific underlayment system beneath foam-on tile Created by Independent Third Party: Yes sytsems. Refer to ER Section 5.5.3 for details. 2.) Refer to ER Sections 5 and 6 for other Limits of Use. Back L I Contact Us :: 1940 North Monroe Street,Tallahassee Fl.32399 Phone: 850-487-1824 The State of Florida is an AA/EEO employer.Copyright 2007-2013 State of Florida. : Privacy Statement::Accessibility Statement:: Refund Statement Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395. 'Pursuant to Section 455.275(1), Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public.To deterrnine if you are a licensee under Chapter 455, F.S.,please click here Product Approval Accepts: ED® ®a Securitv+trrRit mi WRIM https:Nwww.floridabuilding.org/pr/pr_app_&I.aspx?param=wGEVXQwtDgsQFc5Kg/p2fTrZeHYB7UCe5KMr8%2fye5dEpeyTPSmGoAP16iA°/g3d°/n3d 2/2