54 W 9th St RERF19-0139 Shingle %'S'"`''' c, REROOF SHINGLE PERMIT PERMIT NUMBER
, _��. ., CITY OF ATLANTIC BEACH RERF19-0139
,r ISSUED: 10/15/2019
800 SEMINOLE ROAD
`;iii}:-2" ATLANTIC BEACH. FL 32233 EXPIRES:4/12/2020
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:
54 W 9TH ST REROOF SHINGLE SHINGLE ROOF $8000.00
TYPE OF REAL ESTATE 3 ZONING: ' BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170768 0000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
JACKSONVILLE
PIMENTEL ROOFING INC 402 St. Augustine Blvd. BEACH FL 32250
OWNER: ADDRESS: CITY: STATE: I ZIP:
FIRST COAST LANDSCAPES 30 NINTH ST ATLANTIC BEACH FL 32233
LLC
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 $95.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date: 10/15/2019 1 of 2
;S'-'L`'%�,, REROOF SHINGLE PERMIT PERMIT NUMBER
� =: CITY OF ATLANTIC BEACH RERF19-0139
'rl
1
800 SEMINOLE ROAD ISSUED: 10/15/2019
-.1',.. ATLANTIC BEACH. FL 32233 EXPIRES:4/12/2020
Issued Date: 10/15/2019 2 of 2
�• ' ,� Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
WI�r IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: �r 9ror57.. itss,� Permit Number: RGRF( - 0139
Legal Description/j•-3 i/ /7'2�'.25,:c,47'1.,,,,Le_a',_„.sa Srz,{/Ae/S7/,t&4 RE# /747a—CGCe
Valuation of Work(Replacement Cost)$ 8 000,0 Heated/Cooled SF ,77,S-GG Non-Heated/Cooled
• Class of Work: ❑New ❑Addition 2Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): RCommercial ❑Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ONo
Describe in detail the type of work to be performed: F(...__. 7 -- iCi I`l J ,o^aff,,
WIIT 1--- erje-
SLiu.5,/.. 74.44.4,../A,1-E'1.3,6-" 54-- LA.%)A4l./l-tfanciI. rSOft 1' JK.ws�lr i'e`/44;I Y/E.e46.=f
Florida Product Approval# / /e/a S/,� for multiple products use product approval form
Property Owner Information J N.{. cC `S,i' La kac90e-- //I� P
Name 7-e,a /`�./,,,((4 f. Address ?Ark-7jt'r, to.,4-1-
City Ay-A,4_,v..,L, f1,44.4.., State a Zip Phone 64ey} 7,1-(F c 3
E-Mail J
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
� r"� .
Name of Company A.t6A.,1( ,aS 4-ive_, Qualifying Agent g..1.m t) J 0,14 a,f -L
Address .6Z. 47: 73J4;d i City c3 4.A Ak,4Ot.c State '0 Zip 3 72
Office Phone .$"4'/.� f'j Job Site Contact Number-P.A.Li ,$'y/- $1*
State Certification/Registration# E-Mail
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date +'k i
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOU OT E OF COMMENCEMENT. _
(Signature of Owner or Agent) Sigrfature of Contractor)
Si n d and sworn to or aff geed)before�rlVeitlAis/ day of ig -• and sworn to(or aff -- : •efore me this .5—•-. •f
�� , by 4 Oil.:44 iiAtia, 1' U k ./ , • , by - _ / Ill 5450111r
Its, _ -:!L�J D N'�I �r .Ii
($gnatuu of Nota ����� Signatu� .4(3t. t) y N4
_ y Comm.Expires ii
• August 17,2021 - = My Comm.Expires
• N .GG135675 - - Au9us117, 1
ersonally Known OR ` [ ]Personally Known OR No GG135675
[ ]Produced Identification %� �V$LIG ' 1oduced Identification
Type of Identification: -��iic Or iL��-\\- Type of Identification: tj'> P(JB\.G ��0::
"iiiiIIIII'i
r0/i f, lOFIIF\-p‘\\
NOTICE OF COMMENCEMENT Q
State of c-k ()'C 1d4 Tax Folio No. 1 1 b I O p -00 00
County of D 11 v GL '
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.En ', I - /
Legal Description of property being improved: l(K —3/1 1 7 - a S -?'f l- lrf"I( i4f-tc 6 eiiiA.1 Sec- It
L6 S "�LiL 3 cj �-7 —
� Address of property being improved: SjH, 4 & V). A"k"LGi.lti f Le-t jelvL(1 ) Ft, 3 a-"33
iGeneral description of improvements: I''C_'r(7 ac-
Owner: f(Y Sk- Coco. 0 kg toes L Address: 3 0 q - c1- ? ..9- 3
Owner's interest in site of the improvement: 0 Woe IP— ' b 1 VIII 'e�'
Fee Simple Titleholder(if other than owner):
Name: g-00(-1 y-
Contractor: f I M'I✓✓1+-e- I � .1-v c_ /� 1
Address: '11)('�2,I- S-1- ZA.(–(f/1�C 1'J1 veA U�y ° L1} 'L. 3a a 5o
Telephone No.: "log 9")<� Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone 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 or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to recei• Doc#2019237736,OR BK 18968 Page 1138,
713.06(2)(b), Florida Statues. (Fill in at Owner's option) Number Pages:1
Name: Recorded 10/15/2019 01:37 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Address: COUNTY
RECORDING $10.00
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year rrorn Lne uaie ur rec:ururng urness d unlet enc udcc IS
specified):
THIS SPACE FOR RECORt:IEI4Orky, OWNER
`�s\rY 0TAf? %7,% '5)(Signed: C /P"_� Date: I — 1--(---1--(---Before me this , day of L/,D( • ounty ofuval, ate
My Comm.Expires _ Of Florida,has personally appeared WA.,Uh /'-, ,,
August 17,2021 Notary Public at Large,State Florida,Count/of Duval. I
No,GG135875
My commission expires:
PUB L1G OQ'`� ' Personally Known: / or
l/r�4 OF i;nO)4 Produced Identification:
VrRr,�
+n
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
lip ,-
•
*Project Address: 7 rW 47`, lL r 41L T7„4,,,,7L c i l� -��� Permit#:
*Owner/Project Name: 71i( << //.t,i Ai,.
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.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 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 PRODUCTS
1.Asphalt shingles G-A 1<-LL-{-c 4‘(7/ /
2. Underlayments R t i; S-4, F . sc q
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
Page 2 of 4 Updated 10/17/18
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 10/17/18
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.
, 4401111
*Contractor Name (Print Name): Air)c,, ! `1�(E, -�-C / *Contractor Signature: A
*Company Name: lN,c�,. .-1 ( Ic" e G ��, A; C ,
*Mailing Address: fG7 l�71
*City: � *State: r-4 *Zip Code: 5
*Telephone Number: *E-mail Address:
Cell Phone Number: 5-ae Fax Number:
Page 4 of 4 Updated 10/17/18
OFFICE COPY
City of Jacksonville PERMIT NO.
Planning and Development R E R Fl 9 -b 1 3�
✓ r� Building Inspection Division
ksoNV' OFFICE USE ONLY
1'
Approved by:
Application for:
Destructive Roofing-In-Progress Inspection Date Approved:
VVV
ROOFING-IN-PROGRESS INSPECTIONS
A Roofing-In-Progress Inspection is a required inspection per the Florida Building Code—Existing Building (FBC-EB).
The purpose of the inspection is to confirm any required deck nailing has been completed and proper installation of a
secondary water barrier as required by Rule 9B-0475. This required inspection was not requested by the contractor
prior to completing the shingle installation for the above referenced permit, and now a Destructive Roofing-In-
Progress inspection must be performed by removing certain portions of shingles and/or underlayment to insure
compliance with state law. Not complying with this requirement could affect your insurance coverage for storm
damage.
Owner Affirmation
I understand that the contractor, for the reason listed below, was unable to acquire a Passed Roofing-in-Progress
Inspection. I also understand the Destructive Roof in Progress Inspection will require the Contractor to remove and
replace shingles and/or underlayment as required by the City of Jacksonville Building Inspection Division to verify
work is in compliance with all state and local codes.
Before m /.ay of in the County of Duval,State of Florida,
has perso :ppeared S-111� l- v l(ekx{ 4'i-herein by
hirr elf/he f and affir. - - ents nd decl s herein are true and
Signe...
I / l accurate.
Property OwnerNotary Public at Large,State of 4161
County of
''"•'`! .; TONI GINDLESPERGER Personal) known ,or Produced Identification
*; MY COMMISSION 8 GG 353178 I ID Type: L.
Contractor Affirmation
r � g
Company: el h�Q-�TLI �D ttO s
Address of Project: 5 W)2_ S 9 7-14- S7' �� �,ei��` �\
Requested By: t"-r A-11 El/n I JT'
Reason for Request: Gr�c.c� G DN # 04 r7 614'G K 40 4/0/, k
6Gth") .A //-7)-P/1/(/`fir , understand City of Jacksonville Building Inspection Division procedures
as outlined in Bulletin G-04-08. I also understand the Destructive Roofing-in-Progress inspection is not part of those
procedures and is an exception to the procedure. In addition, I understand that any non-code compliant work identified during
this inspection may result in the assessment of additional re-inspection fees.
Signed: • CJ Date: �/ /
An Approved Copy of this Application Must be On-Site at Time of Destructive Roofing-In-Progress Inspection