278 1st ST - ROOF ,S r
� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
;yr
ATLANTIC BEACH, FL 32233
r,i19' INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF18-0008
Description: Shingle and Modified Bitumen Roof
Estimated Value: 9965
Issue Date: 2/9/2018
Expiration Date: 8/8/2018
PROPERTY ADDRESS:
Address: 278 1 ST ST
RE Number: 172537 0005
PROPERTY OWNER:
Name: MCKAY MARGARET S
Address: 278 1 ST ST
ATLANTIC BEACH, FL 32233-5244
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Tadlock Roofing, Inc.
Address: 1408 Capital CIR NE Suite #3
TALLAHASSEE, FL 32308
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
City of Atlantic Beach APPLICATION NUMBER
J' it Building Department (To be assigned by the Building Department.)
800 Seminole Road ��'
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845 p
E-mail: building-dept@coab.us Date routed: ��U
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Ment review required Yes No
uildin
Applicant: �C�d + ()JL Planning &Zoning
Tree Administrator
Project: 0, 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 B
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:
BUILDING
PLANNING &ZONING2p/
Reviewed by: Date ' 2'
TREE ADMIN. Second Review: ❑Approved as revised. []Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
i
Reviewed by: Date:
Revised 05/19/2017
b
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Serninole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
,fob Address: 2781ST ST Atlantic Beach FL 32233 Permit Number: d
Legal Description 1534 21-2S-29EATLANTIC BEACH TERR SID LOT 11 parcel#
Floor Valuation of Work$ 9,965.00 Proposed Work heated/cooled 2348 non heated/cooled 993
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooUspu window/door
Use of existing/propused structures)(circle one): Commercial csrdenual
If an existing structure,is a fire sprinkler system inoalled?(Circle one): es o N/A
Florida Product Appproval/1 FL#10674 1
For multiple prvdacts use ll approval onn
Describe ht detail the type of work to he performed: RR-3:12 and 1:12 flat roof using Owen Coming duration shingles 18 sqs and
Owens Coming Dock seal self Adhered Mod bit(2ply)5 sqs
Property(Avner Information:
Name: MCKAY MARGARET S Address: 278 1ST ST
City Atlantic beach State FLZip 322gj _Phone 17031 403.3128
E-Mail or Fax 4(Optiowd)
Contractor Inforntaliun:
Company Name. Tadlock Roofing Qualifying Agcnl: Dale Tadlock
Address: 1093 Phnps ruvhwar un t 211 City Jacksonville State FL Zip 32?5 f
Office Phone a Job Site/Contact Number — Fax#
State Certification/Registration# 1328417
Architect Name&Phone#
Engineer's Nanic&Phone#
Fee Simple"Title Bolder Name and Address
Bonding Company Name and Address — ______.___
Mortgage Lender Name and Address
Aly lievtknt a Mrcby muds ar ohroor a lxmur to ria llC work ax/autnllaurxrr m nidiaved I crrtrjy that Ito work or Installation Iran commenced prior to rhe
/rsiurPicr o a panni mM/Ihot all work will he lxr orated is t lbe atolx/ir+l+ojoll laws regolol ng coinrntellon Jn olds/uAsdtcllon. 77r a permit becomes moll
and+raid work Is trot crxnmerxYJ within are/6fmomhs,wcarutrweaatt or Mark n a /Mid or nbartdoned jot anrrJad oj.rlx 6)months at any pine user
. work la commewtd. J lrmlentatxl thol uparrxa permn.T ma+l he anrrrd jot F.'IeNrkal)fork,MumpinA,Sjgnr,(Yells,Fel�•arnacer.Boilers,•Iku/ers,
Tanke rind Air COnditionets,He.
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 Y61UR NOTICE OF
COMMENCEMENT.
I hewh
plmnil lun
cr/((/y JJ�t)I I I411Y n ail aul esnarnx.hhlru� iar ay the same to be erne snit xwrrd.All provnhra n ajlawand onGrurnce+gnvernarg this
typo iwo ill/he wmplict wi r wbriber s tecpte hereat or n. The Haig of a penrat does not p,eaiane to give oulhorily to violate or c+acef the
lwovtaanrtm
.e ajy ndter fede r e.or local�nw,n u/ann ng on o Im Ifotvrntice oJemnlrt/eLar.
Signature of 0%,ier Signaturce of Contractor
Prin Name t�� _�_� Print Name �,�, "7' if ol-
coo 1 s hscri torch to Sworn t and subsep'ted before me
is f this Day of_ ¢ -20(,
le y rc
�..rt.vwts.dir ti
Revised 01.26.10
++n•N ALBERT PAORENU
Notary Public-State of ll
-
�•• • Commission#FF 239295?�. -• e- •:«<��-•., JESSICABURNEY
,R My Corrin.Expires.)vn 9,20 19 Commission#GG 155907
Bonded through Nrdlcllal Natacy Asss., o; Expires Oclober 30,2021
Bonded TMu Troy Fain Insurance 800.385.7019
Doc # 2018018901, OR BK 18261 Page 1913, Number Pages: 1,
Recorded 01/24/2018 04 :52 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
OFFICE CPv
Permit Nor ' (��� K---4
Tax Follo Na. 172537-0005
NOTICE OF COMMENCEMENT
To Whom It May Concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and in aLcordance with Section
713.13 of the Florida Statutes,the following Information is stated In this NOTICE OF COMMENCEMENT.
I. nescription of property:
Legal Description: 1-%--U 21-2S-28E ATLANTIC BEACH TERR SID LOT I 1
Street Address: 2781 ST ST Atlantic Beach FL 32233
2, General description of improvements:-Re-roof
3. Owner's Information: Name: MCKAY MARGARET S _
Address: 278 1ST ST Allantic Beach FL 32233 __ Interest in Property: OWNER
Name and Address of fee simple titleholder(if other than owner):
4. Contractor Information:Name: TADLOCK ROOFING INC.
Address, 7999 PHILIPS HIGHWAY UNIT 211 JACKSONVILLE,FL 32256 Telephone No. 904-236-5200
5, Surety Information: Name: N/A—
Address: Amount of Bond: _
Telephone No. _
6. lender Information: Name: NIA
Address: _ _ Telephone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
Name: NIA
Address: _
Telephone No.
8, In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided In Section
713.13(1)(b),Florida Statutes:
Name: NSA
Address:
Telephone No. _
9. Expiration date of Notice of Commencement(the expiration date is 1 year from the date of recording unless different date
is specified) NJA
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 14 SECTION 713.13,
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A
NOTICE.' OF CONLMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FIN N ING,CONSULT YOUR LF,11DER O AN 1-TORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR N T :F.OF COMME CE T.
Signa AfOw or r Ow a 's at uri,ctt d ct hector artnerti Manager
u
Print Name 15-L
State of Florida
County of Leon-P V-,A� VId
The Foregoinginstrument was acknowledged beforemethisf �^I 13�`� ,20 fR,by
✓Y1►4261R5,r M�/CAl who is Pew me or has produced
7-w/1 i'{7rC � as identification and w1 e an oath.
ALOERTr MORENO CSigAa re
(-If Nittaryi�D`eputyy Clerk
L
Notary Publ c-State of FioI I r
k �'• Cofnmissim.v FF 239295 printed Name
`;i• %" kly Coma, Dlilres j•.a 9,2019
flwdad lhreeyh AadcnM Notary Asan.
" 1
OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA
Project Name: �- )( - C25 0 Permit
Project Address: ZT� l s� 5�,(tt_k �,�i(�"T1L C 1 k �'L '37-7,33
As required by Florida Statute 553.842 and Florida Administrative Code Rule 913-72,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.floridabuildin .or .
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
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 F
10.Wind breaker
11.Dual action
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
I. Asphalt shingles —PAr —L (jL2?44.
2.Underlayments o
w V-
3. Roofing fasteners
4.Nonstructural metal roof
5.Built-up roofing
6.Modified bitumen 011ie r\ r r,7\ L
7. Single ply roofing
8. Roofing tiles
9. Roofing insulation
10. Waterproofing e 7 '
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
11. Wall
12. Sheds
13.Other
G.SKYLIGHTS
1. Skylight
2.Other
Category/Subcategory Manufacturer Product Description Limitation 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) _fG.6 k o C 1C
(Signature)
Company Name:
Mailing Address:_
City:_'Ca orw���� State: Zip Code: x2
Telephone Number: Fax Number:(�L-4
Cell Phone Number:(goLi )_t�5y - 2)(1,`1 E-mail Address:_.� � n
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