364 10 TH ST - ROOF r��`!j
�,, r S CITY OF ATLANTIC BEACH
. ,;§' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
`-'::.7' ;319',. INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF18-0218
Description:
Estimated Value: 8600
Issue Date: 9/4/2018
Expiration Date: 3/3/2019
PROPERTY ADDRESS:
Address: 364 10TH ST
RE Number: 170045 0000
PROPERTY OWNER:
Name: BOYD CHERE J
Address: 364 10TH ST
ATLANTIC BEACH, FL 32233-5530
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: PIMENTEL ROOFING INC
Address: 321 4Th AVE
JACKSONVILLE BEACH, FL 32250
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$7,500.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE) t7 �}yt '7 a o
f zr a4 bo 00
Permit No. Tax Folio No.
State of P7, County of CP f t,'lre
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 5-- (D e)f tviy )---o f 27
f->/l 11 .
Address of property being improved: J 4'c ./0.."1/ S %r A7�(/�„y t C', /7C J4cN�, c(
General description of Improvements: 611 r✓5(L'40 5 61 -Y4 e,('
Owner �-GCht4e"'�c>' •�17 �1
Address 56ti/�� /4;7`"� ST. 14, -iu c_ 'air t r( t
Owner's interest in site of the improvement i.L..Atn2 4740 v 14,
Fee Simple Titleholder(if other than owner)
Name
Address l
Contractor VA in e 4.) f j' m 4 J tom/ �'in l�J t;f I�t e, ..J 5
Address 40 Z. S kid: D.-4.X; '$t,4.4 i Z Z<-7)
Phone No.( 60 6-4/—S-4411 Fax No.
Surety(If any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Llenor's Notice as provided in
Section 713.08(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone 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
Slpn d; tO ,("---DATE df 5
0
Before me this day oft! (8,4 4 In the
County of Dwal S to dde,has ally appeared
Doc#2018fe ' '� � tierelnby
OR BK 18504 Pagehimself/herself and etH that at statem and declarations herein
Number Pages: 1 1741, are true and accurate
Recorded 08/24/2018 12:52 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY t.5‘ ' /2111
RECORDING $10.00 Notary Public at Lan=,State of , County of )7 1!
My commission expires:
Personally Known ✓
Produced Identification
Nowry Public e f Florida
^ Susanna L PeStatarl o
At My Commission GG 227205
' .' too Expires 06/11/2022
(#41.% Building Permit Application Updated 12/8/17
City of Atlantic Beach
mJ 800 Seminole Road,Atlantic Beach,FL 32233
, Phone:(904)247-5826 Fax:(904)247-5845 L ,�1, (G p
Job Address: 3�'4/ / -7.11/1$! Permit Number:R' 0 r
Legal Description j (i el AT eae^n, Lo ?`I fS( � /Z RE# /7Q C) ;7'OODQ
Valuation of Work(Replacement Cost)$ A (.6 p,4.' Heated/Cooled SF Non-Heated/Cooled 2 y
• Class of Work(Circle one): New AdditionAlteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial cResidentiili
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No Ne
• 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:
zz�i;v CI c. SkNay l�h o �, r�—nlct�f ��-�:�1 /•,151L1// S_A, (,,e%exrl,Ay
Florida Product Approval# f/, j Lj 44, 1 -7) ..-'/'a 3, )yr ,4-,z 4-<, for multiple products use product approval form
Property Owner Information
Name: C4x '' 'Y�,, d Address: ,74 /c."7-41 5-7—/
City A11—e(✓i>G r ae... State f/ Zip ' 47-"?3 Phone 7 i 2 _• ez2
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: ' '//n,,,/f. �pp1L/,J ' Qualifying Agent: ort/
Address 4/67 51—, 72/vz19, ( City"SA ;GP,aeL&. Staten, Zip 327
Office PhoneOe ) `i 9 5 9t' Job Site/Contact Number Rdr 5-4,/-53496
State Certification/Registration# C/=C,/3304,3< E-Mail
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. 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.
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.
(Si ture of Ow or Agent) Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this 23 day of Signed and sworn to(or affirmed)before me this 13 day of
, 2cyg ,by ZC•%b' , by
Cl<tatilit-t-c:/ -las/
(Signature of Notary) (Signature of Notary)
[,y'Personally Known OR � Notary Public State of Flonda 'ersonally Known OR
[ ] Susanna L Pearl fir' ' Notary Public State of Florida
Produced Identification ]Produced Identification
s. , My Commission GG 227205 Susanna L Pearl
Type of Identification: .,. . ype of Identification: . .. .5
ate. Expires 06/11/2022
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: 'So, /n Permit #
Project Address: 3a, T 774 S r,
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.floridabuilding.ork
Category/Subcategory 1 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
10. Wind breaker
11. Dual action
17. Other
Category/Subcategory Manufacturer Product Description 1 imitation of UseMEM
Local#
.. . . ... . . ..-.
E. SHUTTERS
1. Accordion
2. Bahama
3. Storm panels
4. Colonial11111
5. Roll-up 11111111111111111111111
6. Equipment
7. Other _ r
F. STRUCTURAL
COMPONENTS
1. Wood connector/anchor
2. Truss plates
3. Engineered lumber
4. Railing
5. Coolers-freezers
6. Concrete admixtures
9. Plastics
10. Deck-roof
11. Wall
12. Sheds
13. Other
G. SKYLIGHTS
1. Skylight
2. Other
Category/Subcategory Manufacturer j Product Description 1Limitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPE PRODUCTS
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) 'R pays 0 0-Pt/et' AA-4 (Signature) yL,..,,,�
Company Name: f [' N1.t."/12/ 72 66 f ' i i C,
Mailing Address: ADZ S-r, A-H
City: A..c i 1ekoLt State: gy Zip Code: g 2 2
Telephone Number: ( 5'9/—5'3-ege Fax Number: ( )
Cell Phone Number: (9p(t) ,,SSL 91 E-mail Address:
4
12. Other
•
Category/Subcategory Manufacturer IProduct Description ..imitation 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
_ 4
9. Greenhouse
10. Synthetic stucco
11. Other
D. ROOFING PRODUCTS
1. Asphalt shingles tetk d h g 51.. 3
2. Underlayments 7
, "1-P- .,24 St.cls. __.� s ► -Rrc
3. Roofing fasteners
4.Nonstructural metal roof
5. Built-up roofing
6. Modified bitumen
7. Single ply roofmg
8. Roofing tiles
9. Roofmg insulation
10. Waterproofing
11. Wood shingles/shakes
12. Roofing slate
13. Liquid applied roofing
14. Cement-adhesive coats
15. Roof tile adhesive
16. Spray applied polyurethane
roof