270 6TH ST RERF19-0038 SHING ROOF PERM REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0038
ISSUED: 3/11/2019
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 EXPIRES: 9/7/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that ma 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
270 6TH ST REROOF SHINGLE shingle re-roof- FL10674.1 $23184.00
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
1725620000 TERRACE
COMPANY: ADDRESS: EMU STATE: ZIP:
Tadlock Roofing, Inc. 1408 Capital CIR NE Suite #3 TALLAHASSEE FL 32308
MEE I -- ADDRESS: STATE: ZIP:
YEATS ALEXANDER 270 6TH ST ATLANTIC BEACH FL 32233-5318
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $170,00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.55
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$174.55
Issued Date: 3/11/2019 1 of 2
Building Permit Application Updated 1019118
CRY of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 270 6TH STATLANTIC BEACH,FL 32233-5318 Permit Number: F H—0 0 :?3�_
Legal Description 1&34 16-2S-29E.1 15 ATLANTIC BEACH TERRACE SID LOT 41 RE# 172562-0000
Valuation of Work(Replacement Cost)$Iz Heated/Cooled SF Non-H—eated/Cool
ed
• ClassofWork: []New ElAddition r-JAIteration DRepair LJMove LJDemo E]Pool LJWindow/Door
• Use of existing/proposed structure(s): DCommercial DResidential
• If an existing structure,is a fire sprinkler system installed?: Eyes FlNo
• Will treefs)be removed in association with proposed project? 11Ye5(MUSt submit separate Tree Removal Permit) F�No
Describe in detail the type of work to be performed:
RR-Slope 3/12 with 29scls Owens Coming Oakridge Shingle FL#10674.1
Florida Product Approval$t - .—for multiple products use product approval form
Property Owner Information
Name YEATS ALEXANDER Address 270 6TH ST
City ATLANTIC BEACH State FIL Zip 32233 Phone 772-321-1393
E-Mail alyeats@gmail.com
Owner or Agent(if Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Tadlock Roofing Qualifying Agent DaJeTadlock
Address 7999 Phillips Highway Unit 211 Citv Jacksonville state FIL Zip 32256
Office Phone 9134-236-5200 Job Site Contact Number 904-236-5200
State Certification/Registration# LIC-CCC1328417 E-Mail Juacquine(§tadIockroofiing.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 0 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 regulating
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
RECOR�ft
_rUR NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirm-d)before me this a day of Signed and sworn to(or affirmed)before me this day of
91e—*0n6'Rf tA &Az45- OLUcK2,Z_�?�eiy
Notary)
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Personally Known OR "'..".K0 Ex nown OR
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L;.Plf,oduced Ide...... DsceMbOr 17 2022 1 1 roduced Iden ication 00 AFGG
Type of Identification: 'an*TIft 7*-'-6 k,,' k -84
W&FO T e of Identification
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7019
Doc # 2019053605, OR BK 18713 Page 1309, Number Pages : 1 ,
Recorded 03/08/2019 03:39 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
Permit No,
Ta.FoOril,!., 172562-0000
State of FL(?ZIDA NOTICE OF COMMENCEMENT
County of UUVal
The undersigned hereby gives rictice that improvement will be made to certajn real property.and in accordance
with Chapter 711,Florida Statutes,the following information is provided in tN5 hotice of Cummencemert.
I. OescrIptici of property:
15-34 lh�OFITPIITRUTIC BEACH TERRAcE S/D LOT 41
STIR E ET��%ReEascs�
270 6TH S7 Ila I'L 32233
Z, General descripUcn of improvement: Re-foof
3. Owner information 3,Les;ee information if the ssee contracted for the improvement:
a. Name andaddress: YEATS ALEXANOEL�
.L70 6TH ST Atlwli,Cleach FL 32231
D. Interest in property:
c. Name and address of fee simple titleholder(if different from—Owner Listed abovel,
4. a, Contractor: TADLOCK ROOFING,INC.,502 CAPITAL CIRCLE SE,UNIT C-11,TALLAHASSEE.FL 32301
6, Contractor's phone number-.850-877-5516.
5. Surety(if applicable,a copy o4 the payrr�"t bond is attached):
a. Name and address:
b, Phone nurnloer:
c. Amount of bord:S
6. a. Lender:
b. Lender's phone number;
7. Persons Im Oin the S t Ate of Florida designated by Owner upon whom notices ar o&r documents may be served
as provided by Section 713,13(i)(ai7.,Florida Statutes:
a. Nameandaddress:
b. Phone numbers of designated persons:
8. a. In addition W himself or herself,Owner designates
of to receive a copy of the Liervor's Notice as
provided in Section�_13.i 3ti 1b),Florida S�atutes.
b. Phone number of per5w or entity designated by owner:
9- Expiration date of notice of commencement(the expiration date will be I year from,the date of recording
unless a different date is specified)
WARMNG TO OWNER:ANY PAYMEN75 MADE aY THE OWNER AMR THE EXPIRATION OF THE NOTICE OF
CONMENCEME14T ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PARTI,SECTION 713,1
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING T`WICE FOR IMPROVEMENTS TO YOUR PROPERTY-A
NOTICE Or COMMENCEMENT MUST BE RECORDED AND POSTED ON THE 08 SITE BEFORE THE rIRST
INSPECTION.IF YOU INTEND TO OBTAIN FINANCING.CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
co I YW4 0 0 RJECORDONIG YOUR NOTICE OF COMMENCEMENT.
L
.,,.r n�',
tSignaLure of Owner jor * Owner's or Les�ce'5 Authorized Officer/Director/Partner/
L
Manager) ISIS toW ,
I s "e'O "�j
Manager) (Signato s 70�,01%)
The( . _0 ')i
-d before me this day of
by 4e c-,+5
as
atu,e o N ary Public St te of Florida)
rsonaiiy — OR. o ic e tflic Orin
-vp-e of Identification Produced Xc— 7JACUUMETROMPWN
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COMMU0110 GO 2UO21
E4mill DWrIbir 17,2022
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2. Othe
Category/Subcategory Manufacturer Product Description Limitation 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
Contract�� shall �naintain on the job site and available to the Inspector, a legible copy of each manufacturees printed specifications and installation
instructions At ongwith 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) (Signature)
CompanyName: kpc��00 k�)
Mailing Address.
city: State: Z i p Cod e2,r,)-:2)
Telephone NLIniber: Fax Number:
Cell Phone Number: E-mail Address:-31 %cw_ptkX iw �Oc�vk\ C cno
17. Other
Category/Subcategory Manufacturer Product Description Limitation of t1se State# Local
E. SHUTTERS
1.Accordion
2. Miliwila
3. Storni panels
4. Colonial
5. 11�11-6p
6. Equ rft
7.Other
F.STRVCTURAL
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. Fkck-roof
A ; A
11. Wall!"
12. Sheds
13.Other
FGSKYLICHTS
Y
I. Skylight
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: J�ay�- qnf) <:KQy Permit #
Project Address: D 9 0 Lo�"M '54 PkT1_ 6(AT i c- if)) e a o-iq 'Ie rf- E, Wl I t)t- Li
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 pen-nit 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. rg.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
I. S in�'ing
2. SlfdiAg
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. Winl'brea),,er
11. Dual action
12. Othei-
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. S�pthetic stucco
11.Cft
,�her
D.ROOVING PRODUCTS
1. Asphalt shingles Owe,^%
2. Uiderlayments 171 UL- -7
6-5 cb� 1) 1
3. R:oofing fasteners ,
4.NonSIRICtUral nietal roof
5. BUilt-Up roofing
6. Modified bitumen
7. Single ply roofing
8. Roofing tiles
9. Roofing insulation
10. Waterproofing
11. Wood shingles/shakes
12. Roofing slate
13. Liquid applied roofing
14. qqment-adhesive coats
15. f6of tile,adhesive
16. Spray'apoied p�lyurethane
roof