363 ATLANTIC BLVD - ROOF (2) '' CITY OF ATLANTIC BEACH
;--`., > 800 SEMINOLE ROAD
,�. x ATLANTIC BEACH, FL 32233
x!.cm I.) • INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF17-0022
Description: TPO MEMBRANE- RE ROOF
Estimated Value: 38290
Issue Date: 8/8/2017
Expiration Date: 2/4/2018
PROPERTY ADDRESS:
Address: 363 ATLANTIC BLVD
RE Number: 169730 0000
PROPERTY OWNER:
Name: MANDARIN EMPORIUM INC
Address: 2240 MAYPORT RD#7
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CENTIMARK CORPORATION
Address: 12 GRANDVIEW CIR CANONSBURG, PA 15317
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.
rI�:1Pif��, City of Atlantic Beach APPLICATION NUMBER
�s * Building Department (To be assigned by the Building Department.)
Q-00 F H oozz-
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 D1 IL
I
`Ap;iigr E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 63 A-si- to-v,c_ - De ent review required Y74/o
n�
Building
Applicant: tM) MU l L(po(Q��('� Planning Zoning
r _ ',�/ Tree Administrator
Project: ( L- ( 00 1 I I QB s(c (m V+ &\L _Public 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. [Not applicable
(Circle one.) Comments:60,`/ loot / y /1;p( e oo � � ,y\ Preto/A'S
BUILD! 1� S [id n ��
PLANNING &ZONING Reviewed by: J"21
Date: 7'16 1
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie . ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
•
51 ' Building Permit Application
. City of Atlantic Beach
,� vt 800 Seminole Road, Atlantic Beach, FL 32233 JUL T g 2017
`°st Phone: (904) 247-5826 Fax: (904) 247-5845 n
Job Address: 323 Atlantic Blvd Atlantic Beach FL 32233 Permit Number: }n- 00111 - 00 Z Z
Legal Description Re Roof RE# 169730-0000
Valuation of Work(Replacement Cost)$ 38,290.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio MI Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): C = Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 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: Remove existing roof down to deck. Fasten 2"insulation,fasten 60 Mil single
ply TPO membrane. Reuse existing metal coping.
Florida Product Approval# FL 14207 R-14 for multiple products use product approval form
Property Owner Information
Name: Mandarin Emporium Inc Address: 2240 Mayport Rd. #7
City Atlantic Beach State FL Zip 32233 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: CentiMark Corporation Qualifying Agent: Glenn David Tredinnick
Address 2780 Gateway Drive City Pompano Beach State FL Zip 33069
Office Phone 863 241 3716 Job Site/Contact Number 904 722 5808
State Certification/Registration# ccc1328244 E-Mail David.Tredinnick@Centimark.com
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation _
Exempt/Insurer/Lease Employees/Expiration Date
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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.
l
(Signature of Owner or Agent including Contractor) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirrr d)befofe- this ( da
by )t (.'-V , byC" - ,a.v+✓. ,iQ 17�n1
(Signature of Notary) (Signature of Notary)
CHRISTINA TESCHE
[ ]Personally Known OR (jC]Personally Known OR ti.
o •': MY COMMISSION#FF911753
[ ]Produced Identification [ ]Produced Identification
?w EXPIRES November 17,2019
1407)3280mType of Identification: Type of Identification: FbrlCoNoterySorvicocar
Building Permit Application OFFICE COPY
stn\
City of Atlantic Beach
V
''.4Q4119/
� 800 Seminole Road,Atlantic Beach, FL 32233
Q,:" Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: 323 Atlantic Blvd Atlantic Beach FL 32233 Permit Number: PC)C2 /7 — 0 62-Z--
Legal Description Re Roof RE# 169730-0000
Valuation of Work(Replacement Cost)$ 38,290.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio MI Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): C =121 Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No 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: Remove existing roof down to deck. Fasten 2" insulation, fasten 60 Mil single
ply TPO membrane. Reuse existing metal coping.
Florida Product Approval# FL 14207 R-14 for multiple products use product approval
Property Owner Information
Name: Mandarin Emporium Inc Address: 2240 Mayport Rd. #7
City Atlantic Beach State FL Zip 32233 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: CentiMark Corporation Qualifying Agent: Glenn David Tredinnick
Address 2780 Gateway Drive City Pompano Beach State FL Zip 33069
Office Phone 863 241 3716 Job Site/Contact Number 904 722 5808
State Certification/Registration# ccc1328244 E-Mail David.Tredinnick@Centimark.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lease Employees/Expiration Date
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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
7DYOUNdMENT.
(Signature of Owner or Agent including Contractor) (Signature of Contractor)
signed and sworn to(or affirmed)b fpre me t•'s / day of Signed and sworn to(or affirmed)before me this day of
-.1 1 2 j7,by a 4c4\Q , , , by
MIR' ISia y
a‘ Notary Public, t. of Flor
Qa • a (Signature of Notary)
*'„ Commission• FF 163906
��"' My comm.expires Oct.14,2018
•ersona ly Known OR [ ]Personally Known OR
['-produced Identification [ ]Produced Identification
Type of Identification: Fl Type of Identification:
Doc # 2017167321, OR BK 18056 Page 413, Number Pages: 1, Recorded 07/18/2017
at 11:05 AM, Ronnie Fussell CLERK CIRCUITCOURTDUVAL COUNTY RECORDING $10.00
Perm. PermiT
i- 1 Poo-P!? av22
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.Re#169730-0000
County of_Duval
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:5-69 21-2S-29E 1.65 Atlantic Beach Lots 7 to 18,PT lot 19 Recd O/R 17379-984
BLK 1
Address of property being improved:363 Atlantic Blvd Atlantic Beach FL 32233
General description of improvements:Re Roof
\Owner:Mandarin Emporium Inc. Address:2240 Mayport Rd#7 Atlantic Beach FL 32233
Owner's interest in site of the improvement:
i Fee Simple Titleholder(if other than owner): •
Name: •
Contractor:CentiMark Corporation
Address:2780 Gateway Drive Pompano Beach FL 33069 -
Telephone No.:954 453 3901 Fax No: c
Surety(if any) OFFICECOPY
Address: Amount of Bond$
Telephone No: Fax No:
> Name and address of any person making a loan for the construction of the improvements
Name: REVIEWED roR CODE COMPLIANCE
Address: CITY OF ATLANTIC BEACH
Phone No: Fax No. AL
Name of person within the State of Florida,other than himself,des tfaQll f tiAi$ 1113t16Z�hbSddocuments may be
• served: Name: • REVIElft.0 BY: DATE: 7o v �7
Address: •
Telephone No: Fax No: '
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWN R
Atud
Sinned: Date: -/2—/ 7
Before me this / 1. day of ,4,,,t -' 24, , in NIA County of Duval,State
- . . MIRIAM GRIFFIN i Of Florida,has personally appeared /• u `iP a f Dor a-1�'l>
NotaryPublic at Large,State of Florida,Countyof Duva
,�� =°O¢ ' Notary Public,State of Florida S >
J.
' z4 ....,'`',i x Commisslon#FF 163906 My commission expires: /0—/ -- 2o/
!~!' My comm es Oct.14,2016 Personally Known: or
Produced Identification:_v----
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6/1/2017 Florida Building Code Online
rra.r
PIORIOA oePARTMENT OF
Business & Professional Regulation
rOBPR MOUE ABOUT DBPR DBPR OIVMONS CONTAC':ti PR
BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map Links Search
dG'(0
r
Product Approval
USER:Public User
product Approval Meny>product or Application Search>Application List>Application Detail OFFICE C o PV
►OFFICE OF THE FL# FL14207-R14 a
SECRETARY
Application Type Revision
Code Version 2014
Application Status Approved
Comments
Archived
Product Manufacturer Versico Roofing Systems
Address/Phone/Email P.O. Box 1289
Carlisle, PA 17013
(800)992-7663
malpezzi@syntec.carlisle.com
Authorized Signature Joe Malpezzi
malpezzi@syntec.carlisle.com
Technical Representative Robert Patton
Address/Phone/Email 1555 Ritner Highway
Carlisle, PA 17013
(717) 245-7264
Robert.PATTON @syntec.ca rl i sle.com
Quality Assurance Representative
Address/Phone/Email
Category Roofing
Subcategory Single Ply Roof Systems
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 J. M. Nieminen
the Evaluation Report
Florida License PE-59166
Quality Assurance Entity UL LLC
Quality Assurance Contract Expiration Date 08/24/2018
Validated By John W. Knezevich, PE
Validation Checklist- Hardcopy Received
Certificate of Independence FL14207 R14 COI 2017 01 COI Nieminen.odf
Referenced Standard and Year(of Standard) Standard Year
ASTM D6878 2008
FM 4470 1992
FM 4474 2004
UL 1897 2004
Equivalence of Product Standards
Certified By
Sections from the Code
haps//www.floridabuilding.org/pr/prapp dtl.aspx?param=wGEVXQwtDquDEJErtOSCeo%2fMoS587rkm70ZbzYSwTr%2fo1uAGKOC41w%3d%3d 1/2
6/1/2017 Florida Building Code Online
OFFICE COPY
Product Approval Method Method 1 Option D
Date Submitted 01/30/2017
Date Validated 02/06/2017
Date Pending FBC Approval 02/08/2017
Date Approved 04/04/2017
Summary of Products
FL# Model, Number or Name Description
14207.1 VersiWeld TPO Single Ply Roof Thermoplastic Olefin Roofing Membranes
Systems
Limits of Use Installation Instructions
Approved for use in HVHZ: No FL14207 R14 II 2017 01 FINAL AI ER VERSICO TPOFL14207-
Approved for use outside HVHZ:Yes R14.pdf
Impact Resistant: N/A Verified By: Robert J. M. Nieminen PE - 59166
Design Pressure: +N/A/-495 Created by Independent Third Party: Yes
Other: 1.) The design pressure in this application relates Evaluation Reports
to one particular assembly over light weight concrete. FL14207 R14 AE 2017 01 FINAL ER VERSICO TPO FL14207-
Refer to the ER Appendix for other systems and deck 1 R14.pdf
types. 2.) Refer to ER, Section 5 for other Limits of Use. Created by Independent Third Party: Yes
3.)This Product Approval is for Non-HVHZ jurisdictions.
Refer to FL16443 for HVHZ.
MEI I=
contact Us:: 2601 Blair Stone Road,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 mails 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 determine if you are a licensee under Chapter
455, F.5.,please click here.
Product Approval Accepts:
01
Credit Card
Safe
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