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860 Bonita Rd RERF19-0118 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER RERF19-0118 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 8/28/2019 ATLANTIC BEACH, FL 32233 EXPIRES: 2/24/2020 MUST CALL INSPECTION PHONE91 . . BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK • • ' TO THE CURRENT 6TH EDITION1 OF • ' CODE, OF • OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, 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: 860 BONITA RD REROOF SHINGLE shingle re-roof FL18355.1, $7500.00 2569R16, 5680R19 TYPE OF • • GROUP: 171105 0000 ROYAL PALMS UNIT 01 COMPANY: ADDRESS: PIMENTEL ROOFING INC 402 St. Augustine Blvd. JACKSONVILLE FL 32250 BEACH • ADDRESS: KNIERIEMEN DANIEL JR 860 BONITA RD ATLANTIC BEACH FL 32233-4229 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 $90.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$94.00 Issued Date: 8/28/2019 1 of 2 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department "ALL INFORMATION V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY 9 Phone: (904) 247-58266 Email: Building-Dept@coab.us D. p �j IS REQUIRED. Job Address: 6&oAte/ , 944 Permit Number: F—U_F' Legal Description RE# Valuation of Work(Replacement Cost)$ pyo Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition [;Iteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial R111esidential • If an existing structure,is a fire sprinkler system installed?: ❑Yes D1Go • Will trees be removed in association with Proposed roiect? ❑Yes must submit separate Tree Removal Permit ❑No Describe in detail the type ofworkto be performed: 5 ' (.e, `J(il t v2 , Florida Product Approval# for multiple products use product approval form Property Owner Information / Name_DAM Addressligr} ,�a�,�/rte �pQ• City— 7'/�Ay 4,4 State L�Z7 —Zip Phone S—W—�?�a� E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information [� Name of Company R/ 4 e,)� s ,� e f! T/JC rA2C, Qualifying Agent Address '4/02 6T, City City3 LLLA,, _State ;S� zip,�ZZ� Office Phone hoV�_� �'B Job Site Contact Number'/—S�y8 State Certificatlo Registration# V5— E-Mail 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 RES IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TOCM IN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNE E RE ORD G Y URfN TICE OF COMMENCEMENT ) 'T V 1 (�C (Signature of Owner or Agent) (Signature of Contra ned and sworn to W[ fir )bef9r e this 1 of Si ed and worn to(or affirmed)before me this day ! y N � �1 11111 / / ign ur r ) ��1 tine �') L r,.PERGER _ * - _ My Comm.Expires fi s FF 925951 August 17,2021 [ ]Personally Known OR 2019 [. Personally Known OR — No.GG135675 Produceci Identification de rite I �7 ]Produced Identification Type of I en i ica ion: �� ` �" �pe f I ntification: %�' 'PUBUG �` /,//I0F11F�1��. NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. 171105-0000 State of FLORIDA 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: 30-60 17-2S-29E ROYAL PALMS UN IT 1 LOT15 BLK1 Address of property being improved: 860 BONITA RD ATLANTIC BEACH FL 32233 General description of improvements: RE-ROOF Owner DANIEL KNIERIEMEN Address 860 BONITA RD ATLANTIC BEACH FL 32233 Owner's interest in site of the improvement OWNER Fee Simple Titleholder(if other than owner) Name Address Contractor PIMENTEL ROOFING,INC Address 402 SAINT AUGUSTINE BLVD JACKSONVILLE BEACH,FL 32250 Phone No.90-591-5498 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 or herself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself or herself,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 Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expirannd, is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY �-Ow ER Signed: j DATE 1 Before me this day Of — _ in e County of Duval, tate of Florida,hasp ovally appeared h �\\ \\e M himself/herself and affirms that all statements and declarations h n�0 Doc#2019199715,OR BK 18912 Page 21 t o +O N O T 9 �y�����, are true and accurate /�` Number Pages: 1 v N Recorded 08/27/2019 10:01 AM, = My C9n'm.Ex BONNIE FUSSELL CLERK CIRCUIT COURT DUVAL August 77,20 _ COUNTY - N0 GG135675 RECORDING $10.00 Not Public at Large. taeot untyo My commission expireI G Personally Known or Q \� Produced Identification �/, F LOQ'\O\\ /////111111\\\ y �P/RODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA Project Name:—k ,��ey ,�Nt-A) .4mo Permit # Project Address: (L ,,,�,���� f� 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.floridabuildin .or . Category/Subcategory Manufacturer Product Description Limitation of Use State# Local 4 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-throuall 8.Projected 9.Mullion 10.Wind breaker 11.Dual action 12. Other Category/Subcategory Manufacturer Product 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 9. Greenhouse 10. Synthetic stucco 11. Other A ROOFING PRODUCTS 1.Asphalt shingles koo �g 2.Underlayments ALJc 35571 tz 6& 2 3.Roofing fasteners - - _ 4.Nonstructural metal roof 5.Built-up roofing 6.Modified bitumen 7. Single ply roofing 6-k h'r; ye, F 8.Roofing tiles 9..Roofina 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 10 17. Other Category/Subcategory Manuf icturcr Product e Description imitation of Use Stat # P Local# E. SHUTTERS 1.Accordion 2.Bahama 3. Storm panels 4.Colonial ,I 5.Roll-up 6.Equipment 7.Other TF 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 Cateo /Subcate o g r g �' Manufacturer Product Description imitation of Use State# H.NEW EXTERIOR Local# ENVELOPE PRODUCTS 1. 2 In addition to completing the above list of manufacturers, product description and State approval number for the products used on thispro'ec th Contractor shall maintain on the job site and available to the Inspector, a legible copy of each m instructions along with this Product Approval Sheet. anufacturer's printed specifications and installation 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 R (Print Name) � (Signature) Company Name: o Mailing Address: city: State-_EL_Zip Code-_3�� Telephone Number: ( a /// �� Fax Number: ( ) Cell Phone Number: (9p� )_ �, /� �� E-mail Address: