556 Seaspray Ave RES19-0204 Sheathing, Siding PERMIT NUMBER
RESIDENTIAL PERMIT
RES19-0204
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 7/8/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 1/4/2020
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
RESIDENTIAL ALTERATION SHEATHING, WATER
556 SEASPRAY AVE RESIDENTIAL PROOFING, SIDING, SOFFIT $23900.00
& FASCIA
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
-CONSTRUCTION: NUMBER: GROUP:
1707030422 SEASPRAY
COMPANY: ADDRESS: CITY:
KIVIS SYSTEMS INC 1301-C Penman Rd Jacksonville Beach FL 32233
OWNER: ADDRESS: CITY: STATE: ZIP:
TRINIDAD PAUL ANTHONY 556 SEASPRAY AVE ATLANTIC BEACH FIL 32233-4165
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
iRoll 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 $170.00
BUILDING PLAN CHECK 45S-0000-322-1001 0 $8S.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $3.83
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.55
TOTAL: $261.38
Issued Date: 7/8/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be a&cLqned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
-dept@coab.us routed: 63
E-mail: building Date
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 'z>S & e Depqrtment review required Yes No
261ding_.)
Applicant: �P�aqning &Zoning
Tree Administrator
Public Works
_((A
Pro'eGt: '-�>Lolcoc'
C Public Utilities
P'Oopl A Public Safety
I Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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 STATILIS
Reviewing Department First Review: RX*pproved. []Denied. DNot applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: FlApproved as revised. E]DeXed. []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. ElDenied. DNot applicable
Comments:
Reviewed by: Date:
Revised 05ti9/2017
OFFICE COPY
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 556 SEASPRAY AVE ATLANTIC BEACH, FL 32233 Permit Number: kC) - lb,-ZOZ�
Legal Description 35-64 17-2S-29E SEASPRAY LOT 28 BILK 4 RE# 170703-0422
Valuation of Work(Replacement Cost)$23,900.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial ( e=idential
• If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No (:N:/:A—>
• 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:
REMOVE AND REPLACE WALL SHEATHING AS NEEDED. INSTALL WATER RESISTIVE BARRIER. INSTALL 6kMES
HARDIE SIDING AND TRIM. INSTALL VINYL SOFFIT& FASCIA SYSTEM. Z
Florida Product Approval#SEE ATTACHED.
for multiple products use proZct�approvR f(&kf 0
Property Owner Information 3 z-z 3. 7_/ Z_7__�35_ CL . Z p
C4 0 —
W 0
Name: PAUL ANTHONY TRINIDAD Address: 556 SEASPRAY AVE F- Z F_
City ATLANTIC BEACH State FL zip 32233 Phone 904-923-8250 ��q 0 <
E-Mail ptriniclaoits.jiri.com W U
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Cr Z
W 15 0 -4
Contractor Information 0 U. C�
cc t; 0
Name of Company: KMS SYSTEMS INC Qualifying Agent: KEVIN P FITZGERALD �– Z
Address 1301-C PENMAN ROAD citv JAX BEACH State FL zip 32250 W
t, LL
Office Phone 904-568-4211 Job Site/Contact Number 904-568-4211 ;; 0 W
State Certification/Registration# CBC 1258387 E-Mail kevin@kmssystemsinc.com 55 -;Z--EL M
3 F_ a
Architect Name&Phone# L.0 W
Engineer's Name&Phone# UJ W �::
Workers Compensation EXEMPT 1124/2021 > W
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W
Exempt/Insurer I Lease Employees/Expiration Date cc
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 a I[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
RECOR YOUR NOTICE OF COMMENCEMENT.
(SigrK�t �ner or Agent) (Signatu tor)
(including contractor) Z01695r-
Signeclandswor to(or affirmed)before me this,Arl"day of Signed and sworn to(or affirmed)before me this athday of
by by Key;sl
(Signature of Notary) (Signature of Notary)
Personally Known OR Personally Known OR
[*Produced Identification Produced Identification
Type of Identification: El- PL T6S3 -MY-Sq-1102 Type of Identification: Fl- 01-
OFFICE COPY,
NOTICE OF COMAIENCEMENT
State of FLORIDA TaxFolioNo. 170703-0422
County of DUVAL
To Whom-It.May Concern:
The undersigned.hereby informs yo.q.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 COMvJENCMv1ENT.
Legal Description of property being improved:
35-64 17-2S-29E SEASPRAY LOT 28 BLIK 4
Address of property being improved: 556 SEASPRAY AVE ATLANTIC BEACH, FL 32233
Generaldescriptim-of improvements:
11"TALL JAMES HARDIE SIDING WITH VINYL SOFFIT&FASCIA.
Owner: PAUL ANTHONY TRINIDAD Address: 556 SEASPRAY AVE ATLANTIC BEACH, FL 32233
Qwner's.interest in site of the improvement: OWNER
Fee Simple Titleholder(if other than owner)-
to
Contractor: KMS SYSTEMS INC
Address: 1301-C PENMAN ROAD JAX BEACH, FL 32250 M
CL
TelephoneNo.: 904-568-4211 FaxNo. 888-583-3480 q 0
00 2�!K
00 (L
Surety(if any) (D
In
Address: Amount of Bond$ re �!w
----- 0 0)C)
Telephone No' FaxNo: ;5-11 Ci
W
Name-and address of any person making a loan for the construction of the improvernents — 04))6 0
0) M 0 L.L z
Name!
41 "2 z z 0
-0 OZDO
Address: E 6
6 =; 600W
0 z X Ir 0 af
Phone No: Fax No:
Name,of pers.6n within the State of Florida,other than himself,designated by owner upon whom jiotices or other documents may be
served: Name:
Address-
Telephone,No: Fax No:
In addition to ljimsel� owner designates. the following perspn to receive a copy of the Lienor's Notice as provided in Section
713.06 (b),Florida
.(2) , Statues. (Fill 'in at Owner's option)
Name:
Address:
Telephone 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):
TWS SPACE FORRECORDER'S USE ONLY OWNER
Signed: Date: .2
A C)I
Before m this of M the County of Duval,State
Of Florida,has personally appeared I —V
1,R
t h
is
has
PRESTON&MILLER Notary Public at Large,State qf F17hida,County of D".
A,**I"- n I',I
ComminW#GG 151997 My commissio expires: I
Exores October 16,2021 Personally Known: or
S?-,q
Bw-ded Thm Tmy Fain Insuranm m3w7on Produced Identification: F 02 - 3
z)j- 7-L53-461
OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: :7�- Z7 Permit #
ProjectAddress:
As required by Florida Statute 5-53.842 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
?roduct approval may be obtained at:www.floridabudding.
I z. rp,.
Categon,/Subeategor-3, Manufacturer Product Description Limitation of Use State# Local
A. EXTERIOR DOORS
1. Swinging
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
S.Projected
9.Mullion
10.Wind breaker
11. Dual action
OFFICE COPY
12. Other
Category/Subcategor.y Manufac=e= Product DesEcriptEion jimitation of Use State# Local#
C. PANEL WALL
1. Sidj�j TAME.5 15 1 q;L
2.-geffits- 5 IDIAj,(,- tjiN;Zb omrj rrL-
3. E-�FS
4. Storefronts
5. Curtain walls
6. Wall louvers
7. Glass block
8. Membrane
9. Greenhouse
10. S7TFe—tic stucco
11. Other
D.ROOFING PRODUCTS
1. Asphalt shingles
2. Underlayrnents
3. Roofing fasteners
4. N onstru ctural inetal.roof
5.Built-up roofing
6. Modified bitumen
7. Single ply roofing
8. Roofing tiles
.......9,,RQofing insulation
10. Waterproofing
11. Wood shingles/shakes
12. Roofing slate
13. Liquid apphed roofing
14. Cement-adhesive coats
15. Roof tile adhesive
16. Spray applied pol),urethane
roof
2. Other
CategojT/Subcategory Manufacturer Product Description Limitation of Use State# Local#
H. NEW EXTERIOR
UNVELOPEPRODUCIS
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 Est 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.
1,7
7z&11*"6
(Contractor Name) (Print Name) (Signature)
Company Name: AO�W!5
Mailing Address: . a-t'
City: t-7)A<�'K50 tate:
,N) V1 L&5' —1?64,�S Zip Cod
Telephone Number: 6 -F
��- �Z/�I/ �Fax Number:
E-mail Address:
Cell Phone Number: (0j- /