125 Donner Rd certificate of occupancy # CERTIFICATE OF OCCUPANCY
PERMANENT
Issue Date: 02/03/2017
RE Number: 172310-1505
Address: 125 DONNER RD
Zoning: CG
Owner: 125 DONNER CDL LLC
Contractor: ELITE CUSTOM HOMES & RENOVATIONS INC
(904) 686-4818
Application Number: 16-SFAT-1493
Description of Work: Single-family attached dwelling
Construction Type: VB
Occupancy Type: R-3
Approved:
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCUPANCY WORKSHEET
Date Requested: 12�� 13Z I q-
Contractor Name:
Permit #: 411
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: L?""Single-Family Residence
F-1 Commercial
r-1 Other:
Lowest Floor Elevation: (0
Required As Built FFE
The folloudng numt be compteftd before issuing Certy1cate of Occupancy.-
Department Date Notified Date Approved Approved By
Fire Dept.
Public Works
Public Utilities Vawhxt
Building yl- 17 _121,
Planning or
Tree Mitigation
Satisfied
P)CL(_V-P(0"j 1A e
Final Survey with FFE _Lw4es — No
All Re-Inspect Fees Paid — Yes — No
-I'
Termite Treatment V Yes — No
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=Turner
MM, Pest
MlControl
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
125 Donner Rd
Atlantic Beach FL. 32233-4210
PERMITM 16SFAT1493
DATE OF TREATMENT: 1015/2016 21112017
AREATREATED: 163 Linear 989 Linear
IDENTITY OF APPLICATOR: Rashawn Clark JE 218783 Karl McKee JE 250219
PRODUCT NAME: PMM!Se PrO Bora-cEire
CHEMICAL NAME: Imidacloprid Disodium Octaborate Tetrahydrate
(DIFFERENT FROM PRODUCT)
(FOR MIT SMEMS�UST CHEMICAL NAME THAT WILL M USED IF TERMITE ARE DMUED)
PRECENT CONCENTRATION: 0.05 0.23
(MR SAXT SMEMS-IF YOU DONrT HAVE THE�-TEU-HOW MANY STATIONS PER FOCR)
NUMBER OF GALLONS: 66 Gallons 5 Gallons
(FOR BAUT STATIONS-ENTER#OF STATIONS USED)
FINALSTATEMENT:
THE BUILDING HAS RECEI%TO A COMPLETE TREATMENT FOR THE PREWNTION OF SUBTERRANEAN TERMITES.TREATMENT 6 IN ACCORDANCE
WITH THE RVUES AND I.AWS ESTABLE41ED BY TIIE STATE OF FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES. IAGKE
TMATTHE ARM INFORMATION ISCORFECT AND REFERSTO�E ADDRESS USTEDABOVE.
x
TURNER PEST CONTROLUC
MO RAYMEADOWS WAY,SUITE 12
ACKSONVILLE.FL 32256
Subterranean Termite Protection Builder's Guarantee OMS Approval No.2502-054
This forrin Is completed by the builder.
public reporting burden for this collecticin of Information is estimated to average 5 minutes par response,Including the none for reviewing Insiructiore,searching
existing data sounmes,gathering and maintaining the data neeced,and completing and reviewing the collection of Information.This information is mounted to
obtain tomenfits.HUD may not collect this inloornation.am you am Act required no complete this form,unless it displays a currently valid 01413 control number.
Section 24 CFR 200.926c(b)(3],recouires;that the site$for HUD Insured structures must be free of unroll huarls.Irps information collection naluiuse a
licensed!Post Control company to pnome Me Wilder a record of specific entalment Infixtrudion in small bases when It my method other than use of pressure
treated lumber is used for pm�ntion of subterranean ternite infestation.When applicable,form HUD.NPMA.WB must accompany Me to=HUD-NPWA�99-&
Efuliders.past Contact ocampenles,mortgage farmers.homebuyers,and HUD as a record of treatment(or specific homes tern use the informardon collecled.
The Information is me Considered runfidenfial,therefore no Assurance of confidentialityls provided.
Thl.forrA A submitted W prol(ne.)toorstrudi.resse,when prevention of sublent laurnbe Infestation a speoffied by Ine tuber or resbarell by the tender.the
emoted.IsKA.VX
This form A W te,completed by M Wilder.The guarantee is Isrusal by the Wilder to the IWM.This guerantee Is W to be considered!as wsi�r ol.or irr pam of,ary legal rghis
or nessel ftnt day buyer Auer have geenal the culdre.
FHAAaACawNW
Locertion a SUAchann.)(Streal Address.or Legal Dereenipion.Cdy.Stois Am Zip), 125 Donner Rd
Atlantic Beach FIL 322334210
Buyer,tatme
Builder Is As dract,Am complete either Wx I w Iss 2.
1 ZIPAst Cannot Comicarry Applied Treatment(See HIJID-NPMA 996 for beessere Mformaral
Th.undsheitped!Wed.,hard,course,ON a Sam ficersou or oMetheis.auumii.au past connot al("Am throwhed by Sues Wa)was corthmosr,&i beat Am
properly at Me looffich refievenced!abowe to provent�Iblysehshsao herrAbs.The x5rhar further co-fifirs that Ma contract Win Me"conM exuporty mclamned Me
Insaurent materials And ossnume used W W In wifth an Wboalre State am Freeland At wor,requireal by the contact has been congrieted
.ohlers Acted on HU�F%K see.Where not"Plased by Applicable Sus. [be buyer,nor An ittesernal 1.payable 0 the past corace,consen,may
.rdsm IN brotectort grimA st.tocamerbon hurnA.A.Corosen!VIA al coneol pan,noted on the.11sourent for haver information
The We1a,hereby gormenteas MAIL A.1yeboareen Isombe Wastafiken sixuld cosul wiffin one 1.From As,data W,loseng,Me Wilder M toll me A ficareal.1
diunwh.sure authoured past combrol comeny will"At A meserear,W convot Inketwilons in thavarecture.Ths further thealneve will be whil cost at the wyer,
If enrithol by State 1..0.Wyer may contran!do.*,at Me boer'. We .wish a best conful company to Inesw Ithe peberst,on.intrinsic Wse am use
SPA regWerad producte 0 cortirs!Any Infealtassn.The tounder yen not loss matchable for quarandminc,such combraverl wors.The Wilder further seeing Ist Allor all
dAnalge by.1blemenscon balance within M care,ser buider's war"period The gessandes,does hot apply A,arksillons or afteraturts that am made by Me buyer.
arrech affiects the original structures or assenem.Esompas inciusia,Wt am nont sorest Its urroaceps am mulch aftembas whicki dishulto the treated aw am shares
new subterranean beram hateards.or Interfere wm Ihe oonlrui measures,if wuhin be guarantee petim the bustyu questions that vacaly of a cum by me banner,Me
clean we be massets;fted by an untflassel eaW mutually a,,nable to Me Wiser and Wilder.The m,polt of the ex;WA wil les scarcest as the Imas nor dispoesnarn of
the...The non-prevellin,party All My Me t 0 an,ImpeAlrons made W onesUgl.the doints.for turner An.unast,coread your sale saucural past corrym
morass,agency All suarmse must As In compliance with thes International Residential Closer.
esonfe seat steel 01 FrieldApokedWoexlTmestrant WIWI Toodesend
The bulder callfies fent WAAAmeman hermite lovesenflon was Waslani usirg creature Vessead narrow Win and cauffies"use of Me pret swaso senist,.in
cornplancs,with presolle Wasting boors A M HUD requins.more,Mhr,a,ea,feel 2001101.helen Win nessears,".W Mae As A act.memod.1
sure.It mal n 1.NOT Acceptable a Ad vIoNt.Me no.1 hements.1 khm,si,se labor 2001 04.
Insualoflaulder Data
Al urchmarthe
suldn's st"see Des. 2/2/2017
Consumer Mannerisms Antybor,noassum fin"hatind Frost�a�t Im Phreenfism 0 Wood Destroyl M Imart information Argentina pneventon of wood ddreent,
I herso triestalsoh is helpful 0 my property owner Intereasho A prosecting Me structure from iftlestalent my sWcouns can be auixorea by wood destroyers, nefinte
no. Assild house,Aversom.es resume possibeffies of wasurnon in am motaxi. Fachers which may lead to I rd.votion from wooll cerboyin,instrob incksle Obtain
Incursion at forrelaw.earthrwom barren.faulty VW,amassed against"uns,Insentient vom labor,moisture.tecoof dethra,A,smal space.Ascot mesc,.thener J,hunches
toodi slublues.landscape Onsters,Am woral not.mculd these or other such consciti is(,comenev...shoad be taken by Me owner A chher to reduce Me
cleasses of anestafibirs by whorl desmyng heads.am me need for tmamarA&
An VI and.copy or M. ,mareares Am W W onnomed by Me bu Ider aud saut 0 th.harder,The lemer intsveles.col W VIA Wnser at clowng AM Achanshe A bbp,�I'Me,
VA Am pookea.HUD In..tamer Tha In Walter same.copy,b Me licensed pest toebrol cornparty which performsed!the�t,
Aftablesol A,.sup,of Me stats luftsomed saw col consper,.New construct.Sublemme.T..k.Semes,Rectod.HU�.
Mara,HUD we cosmos later bases and Mt..U.Con,,istion may myuK m crinsurd ardthr Mil awswies (18 U,IsC.1 W 1.1 Of 0,10 12:31 Ue Q V 29.39021
New Construction Subterranean Termite OMS Approval No.2512-0525
Service Record (exp 05IM2018)
I.1451onal glegb, P,%lanl.-I CFIF-leverage 15 minutes Par Inducing M fte for reviewing Instructions,
hapa gli an for�!M
I . in Is I.,d
marching existing date sources,gativering and maintaining the data needed,and completing and neviewing ft will of information.This information
Its required W obtain benefits.HUD may hot collect"a Information,and you she not required to compete this I",unless It displays a whently valld OMB
contral number.
Section 24 CFR 200,926d(b)(3)requires that the Mae W HUD ronnedi structures mst be free of termhe hazards.ThIs information collection requires the
builder M paltry that an auttiortzed!Pest Cwhol company perhormad all required thealarmint for termites,"that the bulkier guarantees Me tnmIW am
against Infifennion for one yessr.Stalders.past con"I companies.mortgage lenders.lzmebuyers.ardt HUD as a record of theatmeat for specific homes,will
uss the Information colocad.The Information is not consikkned confidential,therefore,no assurance of confidentiality is provided.
This report is submitted for informatkmal Wnposins W ft bulkier on proposedl tnew)construction cases wherm treatment or nreventior,of subterranean White
Infestation Is specified by the bulkler.ancMect,or required by the lander,anchitect,FHA.or VA.
AM contracla for services am between the Past Conthol conVany and!buflde�unless stated otherwise.
Section 1:General Information(Past Control Company Information)
C;ompanyName: Turner Pest Control
ComparyAddress; 8400 Baymeadows Way, Suite 12 CilyJacksonville State Florida Z1. 32256
Company Susheas License W. JB 112358 CompanyPhoneNo. 904-355-5300
FHAfVA Case No.(if any)
Section 2:Builder Information
Company Name Elite Custom Homes Phme,. (904) 233-4130
Section 3:Property Information
Location of Structure(s)Treated Smset Address or Legal Description,aty,Suite and Zp�125 Donner Rd Atlantic Beach FL 32233�1210
Secdom 4:Servim Information
Galata)or Smiw(s) 10/512016 211/2017
L,---U61her
Type of Conshuction tMore than one box my be checked) �Slatb C.'Basehavent L] Crawl r Mod!Frame
Cinecit all that apply:
FA.$oil Applied Liquid Termficide
Brand Nam of Tiannifiddep"'m Pro EPA Registration No.432-1449
Approx.Dilution(%�. 0 05 AppMx.1blatGaIkxrsM,.ApplimI: 66 Trealmnatcompletedonexterronzyes No
8 WoodAppled!Liquid Termitickis
Brand Nam of 71mnilkide:Es-- EPARegistrationNo. S*IOS-1
Approx.Dilution(%): 013 Approx.Total Gal"I&Applied: 5
C.Bell System memiled
Name of Syslem.EPA Registration No-_ NumberolStationsinstalkd
0.Physical Banner System Installecl
Name cfSystecn�Mach irrsiallalon Information(rexukedl)
ServiceAgrearmentAvailable Yes No
Note:Soma state laws requflZoe agreements to be Issued.This form does M phrenhxt stale law.
Attachments(Ust)
Comments
NanhwofApplicalor(s) Rashawn Clark Karl McKee Certification No.(ifnequired by State is.) JE218783 JE250219
The applicator has used!a product In amortance with the pmd�label ancl state requirennents.Aff materials and methods used comply with state and federad
regulations.
Authorized Signature Gse 2/2/2017
�Z
11ftming:HUD wit poseowe farm claims,am W.�ts my (16 U.S.0 Itch,1010.1012;31 U.S.C.37".
K— 1.eu"�(oachom)
TURNER PEST CONTROL,LI-C.
480 SOUTH EDGEWOOD AVENUE
JACKSONVILLE.FIL 32"5
PHONE(904)355-5300
SUBTERRANEAN TERMITE
RETREATMENT&REPAIR SERVICING AGREEMENT
Customer Name:Current Resident Else
Covered Premises Address: chAt"Ni
City: ��� State: FL Zlip Code:3223DaI21O
Treatment dew:IOISQ016 WIM017 WOO Thostramet Shelter Locaboda
T,faaeofStracture: COMNERML MULTIFAMILY DWELLING
Type of Theatments
—X—Paponeduchwer E.Iwfln,watched wood end It.
beral
THIS AGREEMENT WILL BECOME EFFECTIVE OPON PAYMENT IN FULL AND IS SUBJECT TO THE GENERAL TERMS AND
CONDITIONS ATTACHED HERETO. IN SUMMARY.THIS AGREEMENT PROVIDES FOR RE-TREATMENT Mo REPAIRS FOR NEW
DAMAGE TO THE SPECIFIC ME"WITH A LIVE INFESTATION TO AN AGGREGATE OF UN,NO PER BUILDING,SUBJECT 10 THE
GENERAL TERM AND CONDITIONS ENCLOSED HERM.
CME�E:Far a perpoll of five Ware beginning on ow treatment d.w.h.saft hoop.Tom.,Past Cannot.,.en a.m.in.repawass,
tenithead her me-..I I i.aptheareftes.image.fapf�in...it paresdame(also neremed to by.appeal far Me..of I CHARGED TO
BUILDER,Payable oft completion 0 the chat treatment by cash,capack or crealt card Naspled by Tumor Post Control,Ndwd W the enmal
warml cardifiew attached'a able Agmal 11,16Amearmearawasuibleraft...harpriffice mity.
REPAIR:Subject,to ther Depend pramar and�ft�ns surprised,Wsubtaftempan termite damage occurs In or on Me conamed promis,whim
We agreement IN In affect.Man Turner Past Compal will be responsible far the wasomplade costs of papars an deappreffired by Turner Past
Carl subject a,the apparel Radiation Terms Fast Can"[Is not awspreftle fe,any repair payments unless Tumor Past Demerit a
been garaft Me opportunity W Impact ins covered prearrial In the area requiring repair near an me strat offany repair
Following Me expiration.1 the hall Me year marryint,mpr.d...bj.ct to th.mnaWinimpowl fee.being paid In mnand.m.with Me
handans and comi by Me*pukpyble hormonal ms�l�n.WMM PEST CONTROL ressamens the right to completely hall
the appasureard parraftelaw.at..1.determined by TURNER PEST CONTROL and agreed to by both partf- ador to Me work Wing
performed.and customer entering Into a new samical afteamant.
INSPECTIONS: Turner Pont Continue we perform an annual Impaction on all buildings owared andertars 0ganumak durn,Me InWal Fthe(5)
,wrjawrod.
Montannuar Amount S as
Mortaffeal —a Amount III
M..tw.l Ancona: I,
Monfla"ear Amount: , an
RENEWAL:Foal M exandon Oflinflouraft(4),tear rental TILARNER PEST CONTROL,rompos Me III NNappelabehImImal the
covered premises at a rate waspandraid by TURNER PUT CONTROL and causterner entedfing Into a new sandal segmented
TERMINATION: Thl. awarmant an,I emandmated y TURNER PEST CONTROL at am lime 0 customer falls W conaw,Win its obigafflons
under the agreement shat gememl terms and condepors attached. The whinciftear muse pay the annual ansplamon fee a,the first day ad the
eapimucial month grille treadersurt expiration al IN the expastion month each yeser)of Me dralrous agmenora.a,the agreement 01 be
tearrunaland.
TRANSFER OF OWNERSHIP AND STRUCTURAL CHVINGES;The customer agrees to notly,TURN ER PEST CONTROL of any�Mms
appear summers W me hatermal strompre. Thus may reliable Me customer to pay par saddleoned treatment seMner annual mayor adjusaftent
to IN,annual rommanal Me. In the sweet the property he hade,by property ownwer a the thre of each ham,al.if.preanew.peral naw
purchased.&hall tern,the call 0 amending the afteraftent,annually after the firriat year far no less Man 4 addiftherail years TURNER PEST
CONTROL reservere Me,debt to afterge a fee ka megin Me spandril to the new owner and to afterat the annowl forward fen upon Waster of
cameril In the event the new owner fails to released continued commage.or does hat pay the annual mmereal fee the agreement wit
twel antormadleally as of Me data at the change 0 ownership. The handed!appeand fee will net be farforphad in h.le ed pill due to
traftshordownershe of Me treated structurs.
CHEMICAL SENSITIVITY:At the bableameaft Wrenn Nepalese,TURNER PEST CONTROL will prow'160 plearrachat about Me chemical.se be
used In maning Me cimereft!prearless. If comWinner or any mander ad Warner household am a may as safteftlare W chemicals or chemical
ancen.appeourner should coming with hall physician tanker chemicals am applied In,on,or under Me houl
AMMMMON:The customer and TURNER PEST CONTROL agree Met any Naval or arm common thern, it.,,but of a,Nl.tl,,,.
Me Interpretation, psnammumain or themeach 0 any pawlsions;of Pris agreement.sinall as settled excluslamt,by a�itmon admineseafted by Me
Anneemain Araftandmin Association,under IN cournmearaidal avotal fees.and lodgement on Me sampral federal by in.anailmaeft.)may be
entered in any court havang jurisdiction. In an sprent small other pay,IN Nude to the cannor far imilard. pacreff,N conse,al its.,.m,
Ifts"at antedpak"I prage.
no lambda form of this agreement ce-WIN all 0 the terms and canal of the agreement andel no other reppoestatiors,a, taampaprU"it
IN binding upon Me parlms. The happaings are for corwandance and ease of masculine chifte,and do not awassearly�d only all Is
memanand In the heading No aftemarim of car majdams to this personal father than�f�hall In Wanks)am affacm.a, rhap-mle
unla=a aftiampNen an IN signed%n.d......W.1houl orTURNER PEST CONTROL was Me-r,m.wpaI 6 penced thomon. ThIs
a mm:aidditipan
A,l ��IPDMW. —mm nd a.attached ralplaided by customer.
go' "m 8
T l
URNER FEET CONTROL REPRESENTATI
DATE: mal
GENERAL TERMS AND CONDITIONS
Thas lleadearm voolland buTdom.,Fmad Cmdool 1. .a-an asual romenual ran a,lmWI.aI...all, a deresed areadaudy,a,
T—c P at Consul to Me 51rand I.rm Insamort a I the Mandred atermormure moornes)11 Edra'a Pre al—I.A.dNWI he babot.
oe"m or n sonernmem,
nodra'd..'_'e'b"an"ar.ond any.....an
Torear Poor.-youl a no d'ad areas)am'.mamly'don,I,dr.moc'.Nd'almormarm.'amoods.) .."And
rablumas do,armandla)am Need 1,and damaged sdom(r�In,daymoda'91 broneysideradOLD DAMAGE and a NOT bar dayeame
WrIZImenIalarrablagreareml
.........t Conrad,'o—don m'er."Anno,W.m d.A adornment
An r"a—an,,I on Pernamere or ransomed by Turner PorlGaretral Parronerel Art adernAbreartermt up-brourearE
yous' —a
-..a am e,und P....I.M.yarroundsonm.(" a.........
arprons'gd.drand a,Trans,Past Otmearmy
Turner Paul betatron�I Ismal no,and la,myred am.aNl,ad by..Ima.b.lablaroullyr,I..(,)Innoadong to a.
donead.m.'alandlarear.
emad.anan's lydral ",a I,..a,.,.I'm eda
Ormate each Wean to be In me aperam 0 Turner Past Control cragnme and one syyxlum�anal be repeated Pat nal
ashanusurememandell........ T.annollwat
Thi,eveldraysmace,mr A,dTwa�PIGICont�w�ln��tospn3�lafw
amboad's madoomal,.carearnA.I.Il,
lamendaveradedayrnalaNniOnarandual
Ro,srousterand artoposs to any ares(s) rare ansda torques Myra4mor
elestaorda.mdemlyeardyi.raduabroard
..ramsereard.1yaluary so.1 narral) We nocarated ered.11.1cludarea 1.1MIsam. yNL.dn.mrr�rmt rouled. ads,
number, soureass andeareard"'o—Mmeam.samse,alman'damn dearryments.emormadesen.a.,nmuslarms,
analm,arep.,--a round... an,nearadden stems unbe..I, a.do"and.,buy......y am., da.anmin a,,A—,
aryouses rumoure room ad reareme stood reare
reaser ar.la, mare radmaded candual.tm�dyyas,tat at'—led..,a,
Ounnarmn.pand,
Parmanal,a1ma danutbasynInumt.adble,romalm
Is mem"Ityra,.1 damaGol amnale
andual
dam,or ord,lulatmAl cloords, MAINE ad unr and ames,of monstal.1 nrom moment,
t...I to any areas neyeare Turady Par dentinal be,documented coactrearm donsuraNne to rommeaus,that ham no,been
dearmand by un,emourander
P.-Imenaralt as .,In 1.May arms Pem layseral Part bar sum u.neNtl drawatc.cauld-or to finseass-sout Inam on
been nuesoland dl am 1.1marral
Cuumener.ar A re,'at neany-so.'IN T.—last Coal,.'or,yed aroa adandamal I..d And an,normal........mantruse any ary.had
Ema Any sonme o'-ad e as-area m.,to to n.anery by In prantsd...promme..(,) 1.1.Ild doomery area Is A.An A..on so on man a a,
11"onyindidandarsournarn fee—
coner-amano"reabod
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