1850 Tierra Verde Dr RERF19-0086 shingle re-roof permit REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF19-0086
800 SEMINOLE ROAD ISSUED: 6/14/2019
ATLANTIC BEACH, FL 32233
EXPIRES: 12/11/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, OF • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASEREAD .
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1850 TIERRA VERDE DR REROOF SHINGLE shingle re-roof- FL10124- $12094.00
R21, FL18686-R1
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
• • GROUP:
169542 5062 SELVA TIERRA
COMPANY: ADDRESS:
RELIANT ROOFING INC 4230 Pablo Professional Ct#155 Jacksonville FL 32224
• ADDRESS:
CHRISMAN LIVING TRUST 4100 QUEEN EMMAS DR 4100#31 Princeville HI 96722
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 • •
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 $115.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$119.00
Issued Date:6/14/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
r s)
CITY OF ATLANTIC BEACH RERF19-0086
800 SEMINOLE ROAD ISSUED: 6/14/2019
j ATLANTIC BEACH, FL 32233 EXPIRES: 12/11/2019
Issued Date:6/14/2019 2 of 2
Building Permit Application Updotedl0,a1,c
xj City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept _ coab.us IS REQUIRED.
Job Address: 1%50 1 t fro- Ve e Dr: Permit Number:
Legal DescriptionS-2)9 (�-of-o{-lE �el�. eyra W} 31 „�REla1������a`rj�(��na
Valuation of Work(Replacement Cost)$_1aL oo Heated/Cooled SF _Non-Heated/Cooled
• Class of Work: ONew ❑Addition i A-Iteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial RrResidential
• If an existing structure,is a fire sprinkler system installed?: Dyes VNo
• Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit VNo
Describe in detail the type of work to be performed:
Y�roO� 3os , x/12 }61) shin 1e5 F�L1o�2y - �21
Florida Product Approval# `OLI=L a for multiple products use product approval form
Property Owner Information / \
Name (iSrnnc� 'IYi �r �S� 1 o�P(� r'S�K�h�lddress 1-}��(� [��IPen �cnpa5; Dr. *.31 -
City Pri riCPyi1 _- _State NT Zip � tZZ Phone�QH—`0�~ &I LA Il
E-Mail mit �.�'jr't�e_ .11�L�P(5
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Qualifyl�nt yY1P
Address �� �� � d�xtnpe,
City State Zip 3zZ�_
Office Phone ,o - Job Site Contact Number
State Certification/Registration#CZKA:93Q(al 5 E-Mail ta.MQ,ndn--�C�1�n�i
Architect Name&Phone#
Engineer's Name&Phone# _
Workers Compensation Insurer' _OR Exempt❑ 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
RECORDING)V NQ ICE OF COMMENCEMENT.
of Owner or A ent
(Signature g ) ature ctor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this la day of
::&,a e by�Ohm Nrisrno,3by Pi
(Signature o otary) (Signature of tart')
..o.dw..v.mw..O.A.
r,, :d' ., AMANDA JACKSON / �r6�;o AMANDA JACKSON
/P.r.,onally State of Florida-Notary Public [`�1 Personally Known OR ?�° ;State of Florida-Notary Public
[ ] 11
Produced 8 Commission M GG 205328 [ ] Produced Identificati =r `= Commission#GG 205328
Ap,lnq 9092
Type of Ident a My Commission Expires �aF `oMy Commission Expires
yp Type of Identification:
gl_ .--
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA (*REQUIRED)
*Project Address: ' rin Ile rf1 V e f , 7fPermit#:
*Owner/Project Name:�,Y\Yi�rnQ.�1 1Vt►'1Q 1 1( Lxc,+ — 1 2 0 Era�rde, Df,
As required by Florida Statute 553.842 and Florida Administrative Code Rule 96-72, 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.org.
Category/Subcategory Manufacturer - Product Description Limitation of Use State# Local#
A. EXTERIOR DOORS
1.Swinging
2.Sliding
3.Sectional
4.Garage 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
12.Other
Page 1 of 4 Updated 10/17/18
Category/Subcategory Manufacturer Product DescripUon Limitation of Use State# Local#
C.PANEL WALL
1.Siding
2.Soffits
3. EIFS
4.Storefronts
5.Curtain walls
6.Wall Iouvers
7. Glass block
8. Membrane
9. Greenhouse
10.Synthetic stucco
11.Other
D. ROOFING PRODUCTS
1.Asphalt shingles
2. Underlayments
3. Roofing fasteners
4. Nonstructural metal
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. Cement-adhesive
coats
15. Roof the adhesive
16.Spray applied
polyurethane roof
17.Other
Page 2 of 4 Updated 10/17/18
i
Category/Subcategory Manufacturer . Product oiscription Limitation State# Loca1# "
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
H. NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
Page 3 of 4 Updated 10/17/18
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 n(Print Name): (1 *Contractor Signature:
*Company Name: t'-�P,kin!L�- `E--oc�Q- r-'Q
*Mailing Address: Pnb to �M C,4, 15 6
*City:Q 'RV dk *State: *Zip Code:
*Telephone Number: ClDq- 666-7- 089 *E-mail Address: (�YYVjrx/40_/a)
Cell Phone Number: Z�- I ?���\ Fax Number:
Page 4 of 4 Updated 10/17/18
Doc # 2019135627 , OR BK 18823 Page 570, Number Pages : 1 ,
Recorded 06/11/2019 09:31 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No
State of Fl,rod County of Duval
To whom it may concern:
The undersigned hereby informs you that Improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved. 38.28 09-2S-29E SELVA TIERRA LOT 31
Address of property being improved: 1850 TIERRA VERDE DR Atlantic Beach FL 32233
General description ofimprovements: Replace roof and interior repairs.
OwnerChrisman Living Trust
Address 4100 QUEEN EM MAS DR UNIT 31 PRINCEVILLE, HI 96722
Owners interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor HomeCore Builders
Address 1123$Si Johns tadusirial Pkwy Jacksonvillc,FL 32246
Phone No, 904-329-2101 Fox 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 of 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 Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owners option).
Name
Address I
Phone No. Fax No
Expiration date of Notice of Commencement the expiration date is one 1 � a
( ( )year from the date of recording unless a CC a ._
different date is specified):
Z a WN
THIS SPACE FOR RECORDER'S USE ONLY 8WNER Z z°�
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in tr,e �'� oEd
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/end aArrns that sll elabmenta and dedaratnxes Aersin o E U O I
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Penronedy Known
Produced idemiUatlon— _ _---- –