221 Pine St RERF19-0088 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0088
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/21/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 12/18/2019
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 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
221 PINE ST REROOF SHINGLE shingle re-roof FL10674-R13 $7200.00
FL17420-R4
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER,
GROUP:
1705640000 SALTAIR SEC 03
COMPANY: ADDRESS: CITY: STATE: ZIP:
Total Home Roofing LLC 2968 Rainbow Rd. Jacksonville FL 32217
ADDRESS: STATE: ZIP:
SPRAGUE JUDITH M 221 PINEST JACKSONVILLE FL 32233
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.
W 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 4SS-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date:6/21/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
RERF19-0088
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/21/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 12/18/2019
Issued Date: 6/21/2019 2 of 2
f
Building Permit Application Updated 1019118
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.
r 11 -15 Z
Job Address: ?,?- I e I'Iv5 64re7r -A O'C' 6 Permil Number: P-L�-F I boR
J & out
Lega I Description es - Z 2 4�7 'S R 1, le_ �ec RE#
Valuation of Work(Replacement Cost) 0 Heated/Cooled SF Non-Heated/Cooled
• ClassofWork: EINew DAddition DAlteration )Uepair OMove E]Demo E]Pool DWindow/Door
• Use of existing/proposed structure(s): ElCommercial ;6Residential
• If an existing structure,is a fire sprinkler system installed?: E]Yes E]No
• Will tree(s)be removed in association with proposed oroiect? Dyes(must submit separate Tree Removal Permit) El No
Describe in detail the type of work to be performed: A c- R40 F (,S h I I k-�- A-eap h A i+ R�00 F,� ov"4 Cb
So lk 7P�f4 41
Florida Product Approval# F-L 4()(97q for multiple products use product approval form
Property Owner Inforniation
Name c )Uelq S-112aafac Address ZZ I
Cit QJLh.L11C Zip &2-?-,,; 3, Phone Zto 67 9
.65?MA State L
E-Mail A-J14A
Owner or Agent(If Age�t, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Total Home Contractors DBA Total Home Roofing _Qualifying Agent RobertDonovan
Address 2968 Rainbow Rd City Jacksonville State FL Zip 32217
Office Phone 321-452-9223 Job Site Contact Number
State Certification/Registration# CCC1330489 E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer-American Zurich Insurance Company OR Exempt o 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 PROPMR-Irv. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDjER 0 A�:T�770 R��N Y [B E F 0 R E
RECO
�RDIUG YOUR NOTICE OF COMMENCEMENT.
(Signalbre of Own�r or Agent) -01&gnature of Contractor)
Sign d and sworn to(or affirmed)before me this day of Sign d and sworn to(or affirmed)before me this Q day of
by Ma P)(� , 2019 by,,��o
(Signature of Notary) (Signature of Notary)
ELIZABETH SANTIAGO ELIZABETH SANTIAGO
Personally Known OR Commission#GG 302986 J4 Personally Known OR
Commission#GG 302986
k,rProduced Identification Expires February 18,2023 [-4-Pfeduced Identification 40 4, Expires February 18,2023
OF Bw&d Thru DidgA Nolwy$wvke# _4
Type of Identification: ;Z"y �v Type of Identification: L4<NFFjdP Sondod Thru Budget Notiry arvll
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
*Project Address: 221 Pine Street Atlantic Beach Florida, 32233 Permit#:
*Owner/Project Name: Judy Sprague
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.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 10/17118
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 PRODUC17S
1.Asphalt shingles Owens Corning Shingles FL 10674-R13
2. Underlayments Owens Corning Synthetic FL 17420-R4
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 tile adhesive
16.Spray applied
polyurethane roof
17.Other Owens Corning Ridge Vent FL 10758-R7
Page 2 of 4 Updated 10/17118
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
H. NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
Page 3 of 4 Updated 10/17118
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):Robert Donovan *Contractor Signat9te:
*Company Name: Total Home Roofing
*Mailing Address: 2968 Rainbow Road
*City: Jacksonville *State: FL *Zip Code: 32217
*Telephone Number: (904) 831-0555 *E-mail Address: Totalhomeelizabeth@gmaiI.com
Cell Phone Number: Fax Number:
Page 4 of 4 Updated 10/17118
Doc # 2019141069, OR BK 18830 Page 1769, Number Pages: 1 ,
Recorded 06/17/2019 02 :26 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(FRETM�E 0 DURLICATE)
Perml No-
'bUVA-L-
To wbom It may ciancem:
The undersigned hereby informs you that irTwor"marrts will be made to certain real property,and in
acc,ordance Mh Section 713 of the Florida Statules,the Aoitlowing linforrviatlon Is stated In this NOTIC E OF
COMMENC EIVIENT.
L-011al desviption of property being Improved: 10-leo - 16-2,�-Z'FC
S #qt7-A(*(2- SEC- A kt,4 !5-357
Ad&e f property being[nriproved� 316-� A rm"e
Gerveral descflptIcn of impfovLment3i
owner J 1j,
Address Tii,p L so:b-t-,a 4- AzbuAF-kii�— r-L, 52-2-33
Owner's 1 nterest in site of ne�m provement
Fee Simple Titlain.older(if other 0an owner)
Name
Address
Contract:;r LHI
Address 2A lok
Phone No. L1 57 Fa;(N a,.
Surety(if any)
Address_ V—) 11(-4 A-ricurt of bond$
Phone No. Fzx Nc�
Narre ard address ofany perscn making a loan forttle co-ristructinn OfRhe:nipnovemerts.
Name
Address
Phone No. FZX Nc�
Name of person withrr State of Florida,other than h:iimn6Vo:r hersa#,designated by owner upon whom
notices--r o0er docurrents,ma,,r be served:
Name
Address
Phone No. Fax No.
in addition 10 hiniself,.Dr-tefself,owrerdesigrate�5 the ldloe/Ang pemon to receivea copy offt Llenor'sNctic-z as
Provided in Section 713.0&(2)Cb),Florida Statutes.(FAI in 31 Ownzi'soplion).
Name
Address
Phone No. Fax%a,
Expiraticin date of Notce,o(Commencement(the explTatori dale isone f 1',year from the date of recording unless a
diflerent date is spectriedY
-USE—ONLY OWNER
THIS 3PAC E FOR RECORDER'S 0
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