121 Donner Rd certificate of occupancy CERTIFICATE OF OCCUPANCY
# PERMANENT
Issue Date: 02/03/2017
RE Number: 172310-1510
Address: 121 DONNER RD
Zoning: CG
Owner: 125 DONNER CDL LLC
Contractor: ELITE CUSTOM HOMES & RENOVATIONS INC
(904) 686-4818
Application Number: 16-SFAT-1492
Description of Work: Single-family attached dwelling
Construction Type: VB
Occupancy Type: R-3
Approved: --E>1 64-�A&K--bA
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCUANCY WORKSHEET
Date Requested: V I 1 13::
Contractor Name: _e�zk
Permit #: 14el Ll
Property Address:
Legal Description:
Improvements to the above-described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as: E21�n gle-Family Residence
0 Commercial
F-1 Other:
Lowest Floor Elevation: (0
Required As Built FFE
ThefoUmving must be compkftd bejbre isming Cardfteate of Oempmtem:
Department Date Notified Date Approved Approved By
Fire Dept.
Public Works
Public Utilities
Building
Planning I 3t or
Tree Mitigation
Satisfied Ia t D(L
W IPA0114 /A t
Final Survey with FFE — No
All Re-Inspect Fees Paid Yes — No
Termite Treatment _ZYes — No
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=Turner
t"Pest
MlGontrol
TERMITE CERTIFICATE
INFORMATION REQUIRED AS PER FLORIDA BUILDING CODES 104.2.6&1816.1
CONTRACTOR: Elite Custom Homes
2304 Peach Dr
Jacksonville FL 32246-3430
SITE LOCATION: Elite Custom Homes
121 Donner Rd
Atlantic Beach FL. 32233-4210
PERMIT III: 16SFAT1492
DATE OF TREATMENT: 10/512016 2/1/2017
AREATREATED: 163 Linear 989 Linear
IDENTITY OF APPLICATOR: Rashawn Clark JE 218783 Kad McKee JE 250219
PRODUCT NAME: P-miwPrO BonB-ciim
CHEMICAL NAME: lmidacloprid Disodium Octabomte Teirahydrate
(DIFFERENT FROM PRODUCn
(FOR BAIT SYSTEMS�USE CHEMICAL NAME THAT WILL BE USED IF TERMITE ARE DETECTED)
PRECIENT CONCENTRATION: 0.05 0.23
(FOR BAIT SYSTEMS-IF YOU DONI HAVE THE�-TEU-NOW~STATIONS PER FOOT)
NUMBER OF GALLONS: 66 Gallons 5 Gallons
(FOR BAIT STATIONS-ENTER If OF STATIONS USED)
FINALSTATEMENT:
THE BUILDING HAS RECEIAD A COMPLETE TREATMENT FOR THE PRMNTION OF SUBTERRANEAN TERNILTES.TREATMENT Is IN ACCORDANCE
WITH THE RUM AND LAWS ESTABLISHED BY THE STATE OF FWRIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SEFAACES. IAGRUE
TILATTHE ABCAIE INFORMATION IS CORRECT AND REFERS TO THE ADDRESS LISTED ABOVE.
x
DO BAYMEADOW5 WAY,SUITE 12
JACKSMVILLE,FL 32256 9�356�5300
Subterranean Termite Protection Builder's Guarantee OMB Apornamil No.25112-0525
This form Is completed by the builder. (am.0513012018)
Public reporting burden for this collectficen 0 Information Is estimated to theariage 5 Minutes per response,Irciticirlill the Unit for reviest Instructors.watching
existing data sounnows,gathering and maintaining he data needed.and Completing Said Missing the collector,of Information,This Information is required W
obtain benefits.HUD reary,not colled Us information.and you am hot required to complete this form,unless it displays a weently valid ONE)control number
Section 24 CFR 200.92!6d(b)(3)requires that the slies,foar HUD Insured structures=at be free off termite,hadyands.This inlormalial Collection requires a
licensed Past central Company to proade the builder a record of specific tivatimand information in thques,cases when It my mefficid other than use of pressure
thisided lumber is used for priamiltion of suldemseal harmite Infestagon.When applicable,fami HUD�PIAA-99-ff must accompearm,the form HUD�NPMA,99wk
Builders,past control winipandea,mortgage lenders,learneWyers.and HUD as a moard of treatment for specific homes Wit use hill Information callmled.
The Information is not considered confidential,In.[.no assurance of coondengality,Is primical
This John Is essential W prolecosed(new) moses when prevention 0 real W enflassare a,Neelfied by Vas Wide ot,required by the lancer,Ve,
shoulso,FHAv VX
This form Is 1.W complotiol by M bealclar.nN rental I,mrsted m,the culaar la the W,,nil .at.li not W be as A yeasts,cy,or to pare ot se,at rights
or materials Ilual he WM ans,It. shil Me boyale,
F�ACnl
121 Donner Rd
Atlantic Beach FL 32233-4210
Buyers Natere,
�W�.wyAppl,MT..�t(Se.HUD�PMnBr����f.W�)
drubmearnew should scour%ithia Ine date circles,
hadastivisayelo,disposiat
"Audi agent All swervics,..at be hicumplians..[in the International Ithohdi Coots.
Typ of St 0 Tisafflas Elat Systathe WI-i-AppledWoodnessinessint WISaineourall IM installed Physical Barmer Sot.
I E51I.Fider Installed!Sulateralwassin Tareaft,Palest ern,Pression,Treated arber
The builder caleflifies fast suble.manit.posesnits, a testified leang assure named lijancel only am area sea .1 he females t,.W leade,..a
colophon.will,transact buddal,codes and HUD mouireassess aided,Mandel Later 2001-0c.Nou.:U.1,pressure tested Mile as a sale method of
larafts parearalon Is NOT acceptalalk,anal Artistes me recularent.1 M.H,,.Later MI 411,1.
lailyaldlaijilder Dah.
Atiscarenis
Submar'lCoar,anythine ishahe No,
Serldessigrialue, Data _3/2/2017
Consumer Maintenance Adhiisal,,regarding integrated Feall�ag�(an Personal of Word Dessoyin,hawarts.Inemearacte recall resistance of yeasel cassette,
lasulaulan at foundation, contact,faulty grado retwori alachat Student.instufficeal Ylablarce,exachers.isood aides hi coast Space.sood mayor,que beenconses
VAquin,cou,scrHUDlesurearecaustmade,
W.,olng HUD MH prousecam feel dalemand seasonal Convolution one,ret in crearel ancaloarc jecanot,(18 U S.C.1001.1010,1012:31 USC.3729,3802)
f.HLD-NPMA-W-Ao3J2W8)
New Construction Subterranean Termite OMB Approwd No�25024Ya5
Service Record text.0&3W2018)
PISMO-'CO
Id .9
M110 "I"ele' IMeM.
P NW—To rd.—. 19 W—W 101I.m. el5m,nWeswrrespwsa,lnciMingftftefbrmv]wMnginsnzu 7a.
watching existing data sources.gathering and maintaining the data needed,and completing arid reviewing Orks coltection of information.The information
Its required to obtain benefits.HUD may not oollect rfs information.and you an,W required to complete this lam,unless it displays a currently vad OMB
control number.
Section 24 CFR 200.9261(b)(3)requires Met the shes for HUD Insured structures must be free of lermth,ha7 .This Information collection requires the
builder 0 cently,III an authorized!Past Control connuany perforated all required treatment for terni and that Me bulkier guarantees gas heated!into
against Infestation for we year.Builders.PW cannot cornparres,mortgage lenders,hornebuyers,and HUD as a record of treatment for specific homes will
use Me Inforniation collected.The Inkmiallon Is not considered confidential,therefore,no,assmance of confidentiality is provided.
This report is sulomittex!for purpossu,to the builder on proposed inew)construction cases when thasament for prevention of subterranean[smile
Infestation is specified by the Wilder.architect.or required by the lender,architect, FKA,or VA.
At contacts far sentices are betweent Me Past Control company and builder,unless stated otherwise.
Section 1:General Information(Pest Commol Company Information)
CompanyNians: Turner Pest Control
CimpanyAddress 8400 Baymeadows Way, Suite 12 ChyJacksonville auns, Florida zip 32256
Company Business;U..W, JB 112358 comparyphori 904-355-5300
FHAAACasa No.(it any)
Section 2:Builderinformathon
company Name Elite Custom Homes lip,onew (904) 233-4130
Seellon 3:Property Information
Location or Structure(a)Treated(Simet Address or Legal Description.CAy,State and Zip)121 Donnei-Rd Atiantic Beach FIL 322334210
Section 4:Sthnilw Information
DaWs)OSenilicefia) 1015/2016 2/1/2017
--kab her Mod Frame
Type of Construction(More than ones box may be checked) F,/ E Basement L) Crawl WIK
Check all that apply:
FA.Soil Applied Liquid Termitickle
Brand Name of Termifiddeprems'Pro EPA Registration No.432-1449
Approx.Dilution 1%): 0 05 Approx.Total Gallons Mix Applied: 66 Trea"kascompleledonextericorzy. No
B.Wood Applied Liquid TlemniMids
Brand Nam of larmisticide; Sons-canx EPARegi5IraIJDnNo
Approx.Dudish I%): OP23 Approx.Total Gallons Mo,Applied:
C.Bait system Installed
Name of System..EPA Registration No._ Number of Stations Metaled.
D.Phynical Banner Systern Installed
Narms of SyStern.Adach histallation Information(muned)
Swr,lce Agreement Available NO
Note:Some state laws requirO;:e agreements to be issued.This farm does ricIt preempt sells lew.
Attachments(Ust)
commerAs
Name ofAMlicalor(s) Rashawn Clark Karl McKee Certification No.(9 required by State law) JE218783 JE250219
The applicator has mad a product In accordance with the procluct tabel and state requmenams.AN materials and methods used comply with state and federal
regigaN�.
Authoxitzedl Signature Date 2/2/2017
'z
lRannIN:HUDMI orcimam,bleat ow,rewillin c`sn0.Iixx'W�QpxrsIhkxr(18 U.S.C1 lath.1010.1012;31 US.C.3M.=n
form HUI"MA�(01342(106)
TURNER PEST CONTROL,LLC.
"0 SOU"EDGEWOOD AVENUE
JACKSONVILLE,PL 32205
PHONE(904)355-53DO
SUBTERRANEAN TERMITE
RETREATMENT&REPAIR SERVICING AGREEMENT
Customer Name:Current Resident:Else Custom House
CovEred Promises Address:
city: ��� State: Ft- Zip Code;32233�4210
Treatment data:101512016 Z1QO17 WDO Treatment Sticker Location;
T,mofSWkpum: COMMERCIAL MULTIFAMILY DWELLING
Type&Treatments
X Preventative, Presumptive(affected wood but no live teraftaftes) Existing(liffeetted WOW and JIM
THIS AGREEMENT WALL, BECOME EFFECTIVE UPON PAYMENT IN FULL AND IS SUBJECT TO THE GENERAL TERMS AND
COND910M ATTACHED HERETO. IN StAMARY.THIS AGREEMENT PROVIDES FOR M-TREATMENT AND REPAIRS FOR NEW
DAMAGE TO THE SPECIFIC AREAS WITH A LIVE INFESTATION TO AN AGOREGATE OF$250,0110 PER WILDING.SUBJECT To THE
GENERAL TERM AND CONDITIONS ENCLOSED HEREIN
COVERAGE:For.paroad of five am original,an AN annit.flat do--1--h Move.Ternew Past Central I—to 1-0m the-wwN-Wy
Moment be me obvional of Matemprown W�.ftw he convered haniflas(its.beftemend W.1.ldrecturift far the am of A CHARGED TO
BUILDER,payable an completion of the fifteat theartment he men check or crown cand sompsed by Turner Post Conabod,subject to Am throveral
burns and conditions attached to this Agreement, This Agreement cowere subterranean withims any.
REPAIR:Subject,0 Me Whomi burns and coaptions,attached,If sublearamen Warren damage Occurs In or on the covereal preadispre.while
Me agreement Is In effect,then Turner Post Channel wlil be responsible for the beflonablu. be.bf set.a.MtWnxNpI by To..,Net
Coal subject to the above lim� Tumor Past Carl Is net responsible far any minor payments prime Turner Post Control has
been Over the Opportunity M Impact Are covered prabill in the area Paper,repir Mor to the super of any repair.
Fallool.,the implinition I the Initial Me abor wernini Had,subject ho the 0....I new.[f..being'to le examples.who ther
herna.and ophadIthan.by Me pikentiol.bromplayeal maraclaill TURNER PEST CONTROL areavers the right to completely rearaft
the covered promither,at a rate determined by TURNER PEST CONTROL and agreed W W both parties prior to the Work Ming
performed,and customer entering late a raw service agromment.
INSPECTIONS: T.MWPMw Cannot NQ wall Malcolm an all buildings Named under Ads agreement pal Me Andal Five(5)
y..r�d.
Montlarrimer. even, Amount
M.MWerat evem Amount A
Montiftfsarn wase Armal A we
Montle'Year, —, Amount: A -
RENEWAL:Following the afternoon Of AS fixtrum(4)year�l.TURNER PUT CONTROL,marearve.the right to complathly Net the
lowered promises at a met Mearrelfted by TURNER PART CONTROL a"purbeent throding late a all thervi 89��nt
TERMINATION: This agreement may on National hy TURNER PEST CONTROL 9 a"time ifebutoomer falls to comply MM IN oblitil
under Me agreement whol general Name and WWIOOns w�w. TIN exporter mud Pay the annual limprobehan ft.tur ins halt day Of As
ex,flopear al Annual moment Wholbution month IN the examption Month mort a,)of 0.pNv[.e .Mp.L or the agreement WE Ifter
befterammid.
TRANSFER OF OWNERSHIP AND STRUCTURAL CHANGES:no W henry TURNER PEST CONTROL deny froditan.
an&oraiMm�sWOO�aWds��. This may requirs the customer W pay for mKINN)MapmwU thervic. adluxbrobin
W Me annual rompanal Ms. In the event Al proper,N Nod.Me proper,Owner at the torm Of each normal 6 a Panama mal Was
p�sw,shall have Me apfiern defending the yourself,animsely after ft AM yearlor no lose Man 4 additional form, TURNERPEST
CONTROL meNn AN right 0�Me a fee W eflogn the agreement to Me sea owner and 0 afteat the Meted minhavel to.upon Member of
ownwal 1.the event Am new.11.11.to afluest continued—�,or deftem wat Pay me annual showed fee Am'wheraini we
Waralreate automatically as of Are date of the arl of oyawl The Name thereof fee will net the reflandred In Whole N pal due 10
tronefir.f.warbia&Me treated sumbeftene.
CHEMICAL SENSITTATT:N Afte customers wagon Name,TURNER PUT CONTROL wil Provide Information about Am chemical.to he
used 0 tomflan ft��Pacrelpari If nualphaver or say��i of hishoper household are of may he sonsiffive to charl Or crearecal
Notes,customer ShOUM cormult with hisfixor phyWcaft points chemicals am applied In,an.lo Met Me litruchare.
ARBITRATION:The customer and TURNER PEST CONTROL agree that any controversy or room between them.mong out of or millions to
Am Inuffriflonfor. or breach of infly pachloom of his agreement.shat be settled exclusively by lableadian animblentered by ft
Antercaft Aftearefion Assucallort,"or IN commernaft liberator rules,and Judgement ch Me award beralMed by 0.wum"s)may the
eniwed in any coust having jumboolon. In NO event"it either party fle Alible an the ofter for afflaral eparell a,cureedus,11.1 dianal.1
I...f anord'sal preffits.
The prated form a this agreement contalba ell 0 the renne and cxondfitione of the agreement and no Other mxmmmmMrw Or eamment, V
be binding upon the promes, The hearings are to,convenience and Cuba Of reference Orit,and 0 not necessarily reflect only Wrat Is
ofmancrodlaltualma.11 ....formal
unwrom the Ideal or all Is t,gned by a expense offeartif TURNER PEST CONTROL wrol the coremits WNI to paread theram. Thib
An. !:mm. 5:�Drfl .and re, aftichollexi loraled Man..,
_,e75A PUT
DATE: aral
GENERAL TERMS AND CONDITIONS
Thin surnermand prontiours IN Turner Past Cleared hi PeNerm Macy andarrand arm dr,ey's"ner,Woundedn's in..ad a.—�a,
Turner Pa.I�Lmdhu 1.ah,Proods.11 th no INI at We Insured scrounlynbou.Noreddhe do hound rahe aduchin. a We�l.
,rundefir.PN—,,
To..,Pool Curnmi.11 Ware.Much damaddins litiods,1.dareent.E.biddurnE ed In.ardeducrommoser,1.We hoularder, I.
Toned,Plot Cement beft NT daragarl added)man a did,obsession a I the spenothed dWdWdPan INN) Unwed No
tobbarydrearden..Ihl Me Num an Man deratiord docan We coure, Ith be bot rad.11111.11 We Wal bh.T bar councered
Unche the.-a at.,a W..—,
To..,last lament ..-a.'yourfe,1. W.n,a but a. ruled.1 WManyhoul
red 1.Pon.,..ar lopermard WrTurear mout CdWI damerill Lady U'.i��by
and, a..,
11 durable.discreddhoor IN he.Nowl it darldhavent he,...hood—rach or mard darroducine aide,
unoldluedi 1.We ,ad—..1 ulareenthed,achrood.).,.a,an,ho accept 11.noundars,or on.counds. cons at
dr,oure Md��by Tumor Pool Canada.
Turn.,Pool conduct Wa mrs on',Past Pa..artual Marietta by true Induction ouldrearraiden INWMINN)Nnareary,to but
Zdo d0ors ditudd herann Tumor Post Contruid 91 dual the resperchan Any match, I emay,mea roydrogs,Nor
dardearall, a.., 1.
(Mand,to.rentapprodestate,WdyddndW.ITMmW1MV�ddWdI
Timealliell
T�ag�ment�snolw,er and Turner Post Commal wat not hadesponeser,to,
Wouddecks radouseas witheamicans wendepynaknodys cur other tWood struchours outside We founalculde�dm�l to We show
sounduchold,radebabol unds,dis in bay or..(,).1 Me truddre Whole—ad reorri I,.In.anyout.grody.
andooday. dr.readar
Tat ra, be I'd do
R.�..t or.,.IN ad all scroll Whole androuther Inintsbaderal don to I.e.NIIIL Mnh.1 hot mI�to I
Idwintlan,hadribut W.do.or To.basis..Ineyours Lord damage foreas crude. .aphroods Put,Way.,crack.1.....
and,dar dricipaL shound WNI sided Idua,m,seem 111.11 ould,as postrob.,noted a, a,andul concrodu Ne Meat endual
to orderadi shoodurbil deare In anden't,.,a thicard
intractable hatiou.,arrom hudy'dard an,.truchuh,.he,marded be har,
D—at.or ushoods a.floned,.11,marthb.alobabill Lou Was Ideareire
Pirelli argerecon,ducludes,but no,11.thear, hantpurnalum or solu,or..Incenned a.No.to Whiculs,mand,
athidernsidn'.or JWWI Wound,
I.do to ad.....'I'da ..a"hodurea I 1'.—.1 to..'M brunded.duaread
to any ammus whom Turner Posta Contact her adulterated candLosers conchandi W afthademen that done M been
_'Na ou,—all—
Fdo-romeaddre N Who,a W any a mou Whole Turns r P eas bonamer Iran thernaboreard cb,duccondi darld— a Whe the Lord bral he 10 10,
WdW.-blad or and
Cusucener roarrands We couberabool yand Tumor Post battery a,,We nocament on.me an,randear and dermy 1.dushe Me Moluccas
Who...'a—�or derhounde conledhere do doludeaddi m Me accrued wescheyead Nrt It is her dol"labouty he counct any
thal elare .be,Joe...con.,a,.,Whaterry��d andualar,by Turner Past Central The dr,becion,We WWr,of shouryon. ,Win,
.......to.due.rN't he.Will IN,.....I num We the by.
such sawded.mado nomadic too vanyl der ah,chorphomanart occur dayseen,Instead aboard! sureaders Thanayourvincher,
....dera reardece,
The cuordear rende,1.par.1 morraw,to Wait. I her acce,urol...as—Mile her usucheal..,shourcuro.a,cleared.—.a,by,Turner
seepeCrend.d.
Funnaluldhourplay
at nature 0.1I Nottrat as addhor date OFMINtlextrudet
Mte�w[tMe�,moFtom,omdpre�esismod,fiod.a�emdo,cNVod.�oWsmy�is,,�,admaddedamuW�ob��l,onn(
W`W liuscrisho
a.adadI handuch.111,baboaddrun.Inotomoldn",ad ofthe data.1 We board,ead
.'Ill.. advisad theland rat an,inearrancoon.,miscreant i WlWrom ty,.1 thromill broyaWan,Thardlect
in hundustoed,caluny other Not %MdgP�tC�lmlhli�,�lO�MiOa%Wda�MG�M
am�the tones ot tiny.....dry Fl,dd,t,,m�,d,�.W.mt�nolths.��.tmt
TurrourPosidCommils
onlyedoWtooka,uh,houldhortle......at phandall We...hand,all—Tiumnor Not Cominal caricau,do In.doodiand binary�.—
rearroure,11thad by Mal D�0�Ml.katcharld but ina madd I M�l���Whether Me ammaddent Was requould by The cu,�r or chossanded
delays,a,To,—,Pool�Nrshrbl
No thadide orrandenum order Man Tow hadvard simadflad sousbakincluded in and UMOI�sagr��
he"nowdlecrutioundal,porthaporhoushousto It sureardshoure and candere thatTromor Poor Comfou War.01 the held noupbouthe No ads I...
11—roon—anyournisT.—PNICimthm