1399 ROSE ST ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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: 16-ROOF-1813
Job Type: ROOF PERMIT
Description: re-roof 31 squares
Estimated Value; $13,340.00
Issue Date: 819/2016
Expiration Date: 2/5/2017
PROPERTY ADDRESS:
Address: 1399 ROSE ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: UNIVERSAL ROOF AND CONTRACTING
Address: 8640 Phillips Hwt STE 5
Phone:407-295-7403
FEES:
BUILDING PERMIT FEE $116.70
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $120.70
PERAHT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
900 Senthele fined.AtImi,Busch,FL 32233
Office(9(14)247-5826 Face(Nd)247-5945
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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 Y6UR NOTICE OF
COMMENCEMENT.
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I
OTICE OF COMMENCEMENT
P.itN Tu Folio No.
State offlorida,Cminty ofDuval
THE UNDERSIGNED botchy give notion that the impamannent will be made to certain real property in wwrichime with
Chapter 713,Florida Stations,the following information is provided in this Notice ofCommencomem.
I. �pon
2. G.vzu funpriwermarme
3. Owner Ifirmontion-
a)Nameand Address: YV&fj
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b)Interest in property _e
c)Name and Witness of simple titleholder(ifothcr than a---)
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it
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0 5. Surety Infirronamon:
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a)Name and Address:
7 0 b)Phone Number:
c)Ammount ofBond:S�
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6. Loader Inlinarattim:
z�0 a)Name it Address:
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0 b)Phone Nurnber,.
in
7. Permit within the State offloridit designated by owner upon whom nations or other doemnents may be served as
Provided by 713.13(1 Xa)7,Florida Stations:
a)Name and Address:
b)Phone Numbers of Designated Persan:
8. In addition to himself/licaself,Owner designate;.of_ in receive a
copy of the Lienca's Notice as provided in Section 713.13(1)(b),Florida Summer,
a)None and Address:
b)Phone Number ofIscrain or entity designated by owner:
9. Fxpmation date of'Notice ofCommeacemeat(the expiration date may not be before the ocarplenon of construction
and final patwent to the eontrattor,but will be me(1)year from the date ofosearding unless a different date is
specified:— —
WARNING TO OWNER: ANY PAYMENTS MADE BY TBE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART L
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 STYE 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 pnna]��ury,I declare thin I bao read the foregoing notion of commenomman and that the facts aided
there., e to c best of y kaowl;��Iief
.Si-- or Owner's 1-M=d
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The foregoing instrument was admowledged befirreme this ZITI dayof jlA14 20_LL_
by MCA ILi E:6Pencc-f as Ncitoxu larvincep
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Applitation Type Revision
Code Vemnom 2014
Application SWWS Approved
cornnne�
Arthived
Product Manufacture Ovie Corning
Address/Pivine/Emai� One O�Ims Corning Parkway
Toledo, 4 43659
(70)4�7829
gr�.keeler@�nswrning.com
Authorized Signature Greg Keeler
greg.keeler0owenscorning.com
Technical Representative Mel Sancrant
Addre.lPh../Emsll I Owers'Corning PONY
Toledo, OH 43659
(419)37&0360
mol.sancmm@me�ornig.com
Quality Assurance Representative
AddressIlithone/lIhmaill
Category Roofing)
Sul,tategory Asphalt Shingles
Compliance Method Evaluation Ili from a Honda Registered Archlb,d or a ucersed
Florida Pi-ofesslonal Engineer
�valuation Report- Hank0o,fa�eiv.d
Florida Engineer or Architect Name who developed Rol�eft I.M. Ifleminer,
the!Evaluation Report
Honda License P&59166
Quality Assurarve Enbtv UL�
Quality Assurance Contratt EXpli-abon Date 08/20/ZO17
validated By John W. Kremylch, PE
4 validation Chackilst-Harick.,Received
Certificate of Independeno. F1 1067A RII 01 1015 01 COI N,em,,en.,df
Referenced Standard and Year(of Standard) Standaind ]JI11111c
AS714 D3161 200
AST14 DW2 2009
ASTPI 071% 2008
Cquivalence of Product Standards
certified By
Sec,dons from the Code
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Produot Approval Method Madhod I Option D
Data SultarrYtted 10/15/2015
Date validated 10/1912015
Data Pending ITC Appr...1 1012012015
Data Approved 1Z(15/2015
S&R.M. car'r.W.
Fill Mosil thermal or Plannar tessellation
10674.1 Caveres Corning Asphalt Rachng 3-tcl�tafllb,�tab,lannineted,starter and hip&ridge
Shingles and Starter. shingles
Limits of U. l�IhOw Insteacdonse
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Impact"instant:N/A Verdled By: Rotert J.M.file look PE-59166
Design Pressure:M/A Created by independent"find Party:Yes
Other: Refer to ER, Section 5. Evaluation Reports
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Corminarts
Archined
Product Manufacturer Oviers Zorning
Address/Phone/Emall One Ovn,re,Oomin,Prk..y
Toledo, OH 43659
(7,10)40,4-7829
gmg.k�ler@�nsmrning.com
Authorized Signature Greg Keeler
gr".keeler@me�oming.com
Technical RepreventaUve
Addrese/Pimme/Email
Quality Assurance Representative
Address/Phone/Email
Category Roofing
Subcategory Unceirlayments
Compliance Metnod Evaluation Report from I Florida Registered Architect or a JCenaacl
Morlda Professional Engineer
� Evaluation Report- Harcloop,Received
Morlda Engineer or Architect Name who developed Zachary R. Priest
the Evaluation Report
Monda Ucanse PE-74021
Quality Assurance Entity UIL�
Quality Assurance�ntract Expiration Date 12/31/2020
Validated By iocke Bowden
0 Validation VheCklhsIc- Harocopy Received
Certificate of Ince,pandence M9777 R5 COI OCRI4002.2 EEC 7014 rvaluatlon RacOrt WeathCEWl;k
HNALod
Referenced Standard!and Year(of Standard) slawadlild Y�
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Debt Approved 08/21/2015
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insprot Randstanto N/A Verified By: Zachary R. Priest 74021
Design Pressure: N/A (Zerated by Independent�hflrd Party:Yes
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FI 9777 RS Ar OCR14002.2 FBC 1014'valuation Report
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Uniftsisfuste Desellardons Instructionse
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Approverl far use Onatelike HVHZ:Yes Weatherl-tick HNALddhf
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Design Pressure: N/A Ceated by Independent Third!Party:Yes
cithear, See evaluation report for limits of use. Evaluation Rephoulas
R 9777 R 5 AF OCR]4002.2 FBC 1014 Fyeu�b,n Report
Weather'ties RNAL.,cff
Created by Independent Irthird Party:Yes
9777.3 Weatherl-ock:Sleidalty Mle&Metal Winitherproofing Unitherlaynnert
Uniftalfuse Deres"Mild.leabsoctions
Approved for use In HVIHIZ: No A 9777 RS Tj �14002,2 MC 2014 Evaluation Reogirt
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Inapsect lUisistant:N/A Verifiedi By:Zanciss,R. West 74021
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It 9777 IS AE OCRI4002.2 FBC ZQ14 Evaluation Report
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