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145 8th ST - ROOF 0 LA/NI 0t1 CITY OF ATLANTIC BEACH S." 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 'x401.119 INSPECTION PHONE LINE 247-5814 ROOF NON SHINGLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROOF17-0004 Description: install roof system with 0.80 muk firestone TPO Estimated Value: 4500 Issue Date: 5/23/2017 Expiration Date: 11/19/2017 PROPERTY ADDRESS: Address: 145 8TH ST RE Number: 170323 0000 PROPERTY OWNER: Name: Sellers Jeffrey Address: 145 8TH ST ATLANTIC BEACH, FL 32233-5409 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Signature Renovations Group, LLC dba SRG Address: 8880 Corporate Square CT#2 JACKSONVILLE, FL 32216 Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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 RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. 1.m. City of Atlantic Beach APPLICATION NUMBER * • Building Department (To be assigned by the Building Department.) r ` 800 Seminole Road t Atlantic Beach, Florida 32233-5445 P-00 F 1-DON Phone(904)247-5826 • Fax(904)247-5845 b ( `o I I E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Props ddress: { S� , ent review required Yes No � /1 Building � Ap• icant: pp-t - [mac () L.L( Planning &Zoning Tree Administrator P •ject: nSkr,1,11 -1P1) N(OvPublic Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: UILDING PLANNING &ZONING Reviewed by: ( F Date: -5 3'1'7 TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. Comments: Reviewed by: Date: 4 Revised 07/27/10 , 1.---'\i' i:'' . CITY OF ATLANTIC BEACH - \� 800 Seminole Road 1t fQ F F C E C O PY Atlantic Beach, Florida 32233 1 f' Telephone(904)247-5800 .... ) FAX(904)247-5845 JF31!' REVISION REQUEST SHEET OR CORRECTIONS TO REVIEW COMMENT Date: J Received by: Resubmitted: Permit mb r: Roo F(-1 - 0004 Original Plans Examiner: Proje t Name: Project Address: /6'5 - 57 € Contractor: Contact Name: Contact Ph . Contact a-mail: ,5',4 , 04017.--a ,Co Revision Plan Check Permit Fee(s) Due: $ Sd.,e, Description of Pro osed Revision toFisting Permit: ,_ - y • ._.__________r_S__.R e r U 6 Q - - l) Additional Increase in Building Value: $ Additional S.F. Site Plan Revised: Public W / U Approval: By signing below. I (print name) affirm that the above revision is inclusive of the proposed changes. Signature of Contractor/Agent (Contractor must sign if increase in valuation) Date orrice Use Only D L 5- 2 7 ( 7 __ Approved: A. _, Rejected: Notified by Plan Review Comments: —Po ckers 4 Q.eac y core. Col /rar CA p,e.h. -�p ,; '..t, Denartment review required Yes o ,may, Buildine0 �' / —Planning&Zoning Tree Administrator Ph : Examiner Public Works - S ' 2 2 -/7 Public Utilities — — --- ..------_..._. . Public Safety --- Date ('rested 4/13/16 Rcv 3 Fire Services %,fi&Is Z4:77`? 7o9 5/5V 8��9 r sy'J:ry,,, BUILDING PERMIT APPLICATION ' S' I y `. CITY OF ATLANTIC BEACH ATE ,�.s 800 Seminole Road,Atlantic Beach FL 32233 OFFICE COPY aril 91'..., Office: (904)247-5826 • Fax: (904)247-5845 � gbh � �do�i 1—000y �.y Job Address: 5//ePermit Number: Ila - 0AkI2 - Z723 Legal Description J) RE# Valuation of Work(Replacement Cost) $ O t Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): NewAdditio Alteration Repair Move D: ; Pool Window/Door • Use of existing/proposed structure(s) (Circle one): Commercial R'sidential • If an existing structure, is a fire sprinkler system installed? (Circle one): es 0 N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: Ti 2571 . /741-4,--. A ‘5Yo'fc'2 be-/.71- . 1.0 /1 z $ c4 7/- O (W/ y,6 Florida Product Approval# / 1084' / for multiple products use product approval form Property Owner Information �,�/ ofd Name: L tY/ Address: O 5/2e-el-- City / eeCity / L i ' ',i State Zip ,33 Phone 90 y fl/ S ?,33 E-Mail ,/C` to M ill ri f ons i ez; Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) v`' n WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTIC ; DFCCECE1�7TEPMAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND EOFINANIINIWEOUR LENDER OR AN ATTORNEY BEFORERCRDING CE CONSULT ME MAY — 3 20f0 Contractor Information: II Name of Company: • lb ,. i)?� . Qualifying A:entBU _'�� Y ' ` • a Address: MO&izpo2/f G 9A, e . nHs f- ' 42 City , ..._t_,J. ,,f ''if: . W.:ea s 5 - a Office Phone 'o - U Job Site/Contact Number qrimi• Le?-,z? yex/VHS: 9 State Certification/Registration# 430333 E-Mail_ ".• i .//P S'Z'/t o/J ,t_o-r, Architect Name &Phone# Engineer's Name& Phone# Worker's Compensation Exempt / Insurer / Lease Employees / Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I cert that no work or installation has commenced 'Trior to the issuance ofua permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. his 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 period of six(6)months at any time after work is commenced. I understand thot separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. Signature of Property Owner: A>/��, �� Signature of Contractor: 0girkfirl,��r"r""' Before me this ?0 Day of MCA. it . Before me this 2) Day ,/ �-, • . %DACODAH PARRISH Notary Publi , / ; Commission Nor} ubc // .# / f Ait, . "A i Expires July 10,2020 * . ' MYCOMMISSIO' 018928 • Y Bonded ThruTroy Fain Insurance 800.857019T4 EXPIRES:September 15, • °', de Bonded TlruBudget Notary Services I hereby cert that I have read and examined this application an'know t e same to be true an1f x6) ect. All provisions of laws 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. Rev.5/2/16 5/12/2017 Florida Building Code Online d FCOPIOA OCPAPTMCYT OF Business & Professional Regulation !i. ill._ FUR MOUE ABOUT 08PR OBPR DIVISIONS CONTACT O8PR BCIS Home I Log In I User Registration I Hot Topics Submit Surcharge Stats&Facts I Publications I PBC Staff SCIS Site Map Links I Search I } Florida 1 CI dr Product Approval \o„.._.....)USER:Public User s s.4 Product Approval Menu>Product or Application Search>Application List>Application Detail ►OFFICE OF THE FL# FL10264-R12 SECRETARY Application Type Revision Code Version 2014 OFFICE COPY Application Status Approved Comments Archived Product Manufacturer Firestone Building Products Company,LLC. Address/Phone/Email 250 West 96th Street Indianapolis, IN 46260 (317)816-3806 Ext 53806 McQuillenTIm@ifirestonebp.com Authorized Signature Tim McQuillen McQuiIlenTim@firestonebp.com Technical Representative Tim McQuillen Address/Phone/Email 250 W. 96th Street Indianapolis, IN 46240 (800)443-4272 Ext 53806 mcquillentim@firestonebp.com Quality Assurance Representative Tim McQuillen Address/Phone/Email 310 East 96th Street Indianapolis,IN 44240 (317) 816-3806 mcquillentim@firestonebp.com Category Roofing Subcategory Single Ply Roof Systems Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer I Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who developed Robert Nieminen the Evaluation Report Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 12/05/2019 Validated By John W. Knezevich, PE 11 Validation Checklist-Hardcopy Received Certificate of Independence FL10264 R12 COI 2015 01 COI Nieminen.odf Referenced Standard and Year(of Standard) Standard Year ASTM D6878 2008 FM 4470 1992 FM 4474 2004 TAS 114 2011 UL 1897 2004 Equivalence of Product Standards haps://floridabuilding.org/pr/pr_app dtl aspx7param=wGEVXQwtDquGotOkaJvZZ61L1RdW5gQh6EkcvegzhAOUWs99PKwU5w%3d%3d 1/2 5/12/2017 Florida Building Code Online Certified By Sections from the Code OFFICE COPY Product Approval Method Method 1 Option D Date Submitted 04/15/2015 Date Validated 04/20/2015 Date Pending FBC Approval 04/22/2015 Date Approved 06/23/2015 Summary of Products FL# Model,Number or Name Description 10264.1 Firestone UltraPly TPO Single Ply Thermoplastic polyolefin(TPO)roof systems Roof Systems Limits of Use Installation Instructions Approved for use in HVHZ: No FL10264 R12 II 2015 04 FINAL Al ER UltraPlvTPO FL10264- Approved for use outside HVHZ:Yes R12.odf Impact Resistant:N/A Verified By: Robert Nieminen PE-59166 Design Pressure:+N/A/-495.0 Created by Independent Third Party: Yes Other: 1.)The design pressure noted in this application Evaluation Reports relates to on particular assembly. Refer to the ER Appendix fL10264 R12 AE 2015 04 FINAL ER UltraPivTPO FL10264- for all assemblies and associated design pressures. 2.) R12.odf Refer to the ER,Section 5 for Limits of Use. Created by Independent Third Party: Yes IBackf [Next) Contact Us::2601 Blair Stone Road.Tallahassee FL.32399 Phone:850-487-1824 The State of Florida Is an AA/EEO employer.Coovrtaht 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 mall.If you have any questions,please contact 650.487.1395.*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 emalls provided may be used for offidal 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 determine if you are a licensee under Chapter 455,F.S.,please dick here. Product Approval Accepts: ®®R® Credit Card Safe HCl 11111\.\11 iiuc https•J/Iloridabuilding.org/pr/pr_app dU.aspx?param=wGEVXQwtDquGotOkaJvZZ61L1RdW5gQh6EkcvaghAOUWs99PKwU5w%3d%3d yy