1841 OCEAN GROVE DR - ROOF ;S f CITY OF ATLANTIC BEACH
) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0207
Description: shingle re-roof-FL10674 & ICC SAC 188
Estimated Value: 9500
Issue Date: 12/8/2017
Expiration Date: 6/6/2018
PROPERTY ADDRESS:
Address: 1841 OCEAN GROVE DR
RE Number: 169598 0300
PROPERTY OWNER:
Name: SMITH KRISTIN LYNN
Address: 1841 OCEAN GROVE DR
ATLANTIC BEACH, FL 32233-5842
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Elite Remodeling Services
Address: 10200 South U.S. Highway 1
St. Augustine, FL 32086
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$7,500.
/f, ; ,. Building Permit Application
; City of Atlantic Beach
T.:,;.:5,,,,-----1)
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address:jeY1 (,tc, e Lae Permit Number: ,�fa-i✓� im
f- VI- - v
Legal Description 90-4o 9'-- .3 .•;.96.oii6 044-4,,v 60"M 04a. SY;f2~iT 4?—
Valuation of Work(Replacement Cost)$ ?„52,0 Heated/Cooled SF WV/ Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration r Move Demo Pool Window/Door
e Use of existing/proposed structure(s)(Circle one): Commercial .' side t.
• if an existing structure,is a fire sprinkler system installed?(Circle one): Yes <IP 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:
hato lilk4i
Florida Product Approval l /047 9' 1 ______. ./for multiple products use product approval form
Property Owner information
Name: /P4 ttgr Sva1 Address: 4Y/ t 4,4v.r ga. r)r
City /,4/40c. State .,4 Zip 3'PP33 Phone VeS-- 74,9—9,Q/Y
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) .
Contractor Information •''4!/� C-
1.0',
Name of Company:e/�,c ctivco,);,�,�J,•c1, 4:16 Qualifying Agent: 0:0 4lh v
AddressAO _{/ S city v 4 • State if--4 Zip 3.?,d¢a
Office Phone lose— • elm) Job Site/Contact Number gate—g57—43 a Z
State Certification/Registration II erre. /33//a., E-Mail AtZ•4"e„ i1iE; 4141.jogC. Coo'?
Architect Name&Phone if
Engineer's Name&Phone It
Workers Compensatiol —" r
11
igel ., isurery LeasVEmployelir/rifilFition 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 allthe 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 NOTICES 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.
Ac_.,.... rte^ /
gnature of Owner or Agent including Contract.r) (Signature of Contractor) ^
Signed and sworn to(or affirftnpd)befor• me this I day of Signed and sworn to•(or affirmed)before me this_�day of
w-ec._ ,20 i-4- ,byLj 1 A' 1 -"6 boss iv) o'
, 2 017,by V3 t an ket. Ye,rt.3
...�..t. i ,.; .....
(SitnttureofNota A. ••• • •-••r , y
tiny Natty 3 'C.:0..
�Irp "t• BAONHAYANG
1_' fllafcryPutsll0 a,
,� � gtaro d Farida : � NOTARY PUBLIC MINNESOTA
O Personally Known +►'; Armon E�ires 11r3BI1a2t [ )personal) Known OR I 'r„ 1�.��4t` MY COMMISSION EXPIRES Ol J31/20
TyProduced identiRcatlo 165172 >I Produced Identificatio t ••
ren i
Type of Identification' _ 1)A (k ( (..... Type of Identification: '1(. t'1t' I V Q irt5 L,1 C
PRODUCT APPROVAL INFO//R��MATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: 43 W 'C W 4//.,n 4 Permit #
Project Address: /ec'( ,10.-
As
/As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide the information and product approval number(s)
for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact
your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide
product approval may be obtained at:www.floridabuildinn.orn._
1 Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# J
A.EXTERIOR DOORS
1. Swinging
2. Sliding
3. Sectional
4.Roll up
5.Automatic
6.Other .
B.WINDOWS
1.Single hung
2.Horizontal slider
3. Casement
4.Double hung
5.Fixed
6.Awning
7. Pass-through
8. Projected
9.Mullion
10.Wind breaker
11.Dual action I
12. Other -
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
C.PANEL WALL
1. Siding
2.Soffits
3.EIFS
4. Storefronts
5.Curtain walls
6. Wall louvers
7.Glass block
8.Membrane
9.Greenhouse
10.Synthetic stucco
11.Other
D.ROOFING PRODUCTS
1.Asphalt shingles , Dwws A,,,k6-4
Fc lQ67Y
2.Underlayments 41,0A.at St,.F4gc, FC ApPr.+.l ifiArrig
3.Roofing fasteners ZCc :5 Ac tat.
4.Nonstructural metal roof I
5.Built-up roofing
6.Modified bitumen
7. Single ply roofing
8.Roofing tiles
9.Roofmg insulation
10.Wateipioofmg
11.Wood shingles/shakes
12.Roofing slate
13.Liquid applied roofing
14.Cement-adhesive coats —"
15.Roof tile adhesive
16. Spray applied polyurethane
roof
17.Other -
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
E.SHUTTERS
1.Accordion
2.Bahama
3. Storm panels
4.Colonial _
5.Roll-up
—
6. Equipment
7.Other
F.STRUCTURAL
COMPONENTS
1.Wood connector/anchor
2.Truss plates
3.Engineered lumber
4.Railing
5. Coolers-freezers
6.Concrete admixtures
7.Material
8.Insulation forms
9.Plastics
10.Deck-roof
IL Wall
12. Sheds
13. Other
G.SKYLIGHTS
1. Skylight
I 2.-Other
Category/Subcategory Manufacturer Product Description I imitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPE PRODUCTS
1 - ,
2_
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the ones
listed in this document must be approved by the Building Official.
(Contractor Name) (Print Name) 1.5/1/4.4. 4l/e (Signatu )-
Company Name: .S4le �C.,,..,�f., SccxeS
Mailing Address: l b aon (,-L,.t ' S
City: S( /.�„��� State: Zip Code: 32-D$15
Telephone Number: (`%oV ) 657— 9 3 8 3 Fax Number: ( )
Cell Phone Number: ( ) E-mail Address: leo,4 Q ei 5 J.ct S/1e. C• '-i
Doc it 2017278567 , OR BK 18209 Page 1887 , Number Pages : 1 ,
Recorded 12/06/2017 12 :30 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTiCE OF CO MMENCF M ENT
Stale of . .Flor:.BAr. 'fax Folio No.
County of. 0v4A 1
1.o Whom It May Concern:
The undersigned herelsy intiirms you that improvements will he made to certain real property, and in accordance with Section 7 1 i of
the Florida Statutes.the following inlixmation is staled in this NOTICE OF COMM NN('I MEN I'. / -!
I.c_tal DMA-4)11011422 -- ag
tic property being improved: 00 9 -2. -� F .D E4 Deewe [}w i. CZ:J- f4 A
S 1/?. too-a.
Address uh property being improved: 1'8 .1 l 0tig"N Ge•ovl. Or 44.4"14.;„ .i e.1.tjr f p4, 3'7A-33
QD
Cicncral description of improvements: . iei t.t F'/#e4'ey( ..34:14,i'S.
Owner: 14 r.:..A./." So.,:ii... Address: fa W 0C1Mv verve 4' 4 /imkr. Q c o6 R.
Owner's interest in site of the improvement: (94un,.,r • . . 37?3 3
Fee Simple Titleholder(ii'other than owner): _ _ . . - . •
Name. _
Contractor: i/:h. Ac."*.4)erj--.7. ✓�tfi.rtcCS
Address: /o€jy .V'>_ 14,41_17. . ' .. ....*7.:.../4.0,uyc'^ti , Az- 3?G S 6
Telephone No.: 90Y.• S7— 93 S.3. Fax No:
Surely(ifany)
Address: Amount of Bond S
•
•felcphone No: Fax No:
Name and address of any person mkt] a loan for the construction of the improvements
Nate.
•
Address:
t'h:me No: Fax No:
Nance of person within the State of Florida, other than In sell. designated by owner upon whom notices or other documents may be
served: Name: _. _._........
Address:
l clepltonc No: Fax No:
in addition in himself; owner designates the Following pet-still to recciv• a copy of the l.ienor's Notice. as provided in Section
713.06(2)(1)).Florida Statues. (Fill in at Owner's option)
Nance: _... . ....
Address: •
•
-
elephone No: .. . ... . Fax No:
Expiration date of Notice of own ine tccnlent(the expiration date is one (1) year from the date of recording,unless a dillcrent date is
spec tied): . .
'1'iIES SPACE FOR RECORDER'S 11SEONI,Y OWNERc •
Signed: `' 15i,vi yv4%6,, (. Dale: 030/(17
x.30/(7
Berme n:e this 30 i+' clay of h tJV 1I_) f-- in the('aunty of[loyal.Stale
Of Florida,has personally'appeared !' _f t S i 1 t) iS f7jr -{ L L r 1)
Nulary I'tild e at large,State al't I rida,f'uunty of Duval. _./ci i 01(.yLC� �hi,C;�LL-�,L_ci,`=
My commission expires: CL f C e I ?C�I( `3
Terminally Known: }'1 I l r of �b
`.Paat�Ue�,/ Timms orFI ri as Produced Itlentiliealion: L. ! i ur- ,' L i C.-L.t� �'�. -F�. Cl f I D J 2o -
�_ �i Slate of Florida
•' —RIMY COMMISSION#FF 130819
°Ft„F`” Expires:June 9,2018
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