1007 Big Pine Key RERF19-0155 Shingle (i'-'
',Irj REROOF SHINGLE PERMIT PERMIT NUMBER
� �,.' RERF19-0155
. ., � ,, _. CITY OF ATLANTIC BEACH
v� _" ISSUED: 11/12/2019
,F; ,r 800 SEMINOLE ROAD EXPIRES: 5/10/2020
ATLANTIC BEACH, FL 32233
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:
1007 BIG PINE KEY REROOF SHINGLE shingle re roof FL10124 & $5625.00
FL21675
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172027 5068 SELVA LAKES
COMPANY: ADDRESS: CITY: STATE: ZIP:
1 ROOF, LLC 33 PANTHER LN #4 PONTE VEDRA FL 32081
OWNER: ADDRESS: CITY: I STATE: ZIP:
Kristoff David 1007 BIG PINE I<EY ATLANTIC BEACH FL 32233-4363
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 $80.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$84.00
Issued Date: 11/12/2019 1 of 2
REROOF SHINGLE PERMIT PERMIT NUMBER
rf
;..., CITY OF ATLANTIC BEACH RERF19-0155
800 SEMINOLE ROAD
ISSUED: 11/12/2019
"0' r ATLANTIC BEACH, FL 32233 EXPIRES: 5/10/2020
Issued Date: 11/12/2019 2 of 2
i=''>,,, Building Permit Application Updated 10/9/18
,-:-,t;',::7- 'I City of Atlantic Beach Building Department **ALL INFORMATION
\,: ./ 1
/ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`''7-'� IS REQUIRED.
Phone: (904) 247-5826/Email: Building-Dept@coab.us Q G /� (�`
Job Address: /007 231got / Ait/ 4 aJi,ft- 32x33 Permit Number: 1-eZ-FI - v iJJ
Legal Description '//- /7 j _9G S ..i..v4 LARKC; L ol- 33 RE#/720 27- -CC9e
Valuation of Work(Replacement Cost)$ .5-6 25- Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration 1 (Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial EpResidential
• 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) ❑No
Describe in detail the type of work to be performed: 5, 6. t=
Florida Product Approval# - SEE ,<.. "---k._ for multiple products use product approval form
Property Owner Information , �,,
Name Kra $>La4 L)dV16( .T Address 007 //� p/p✓t K67G T 16.E
City /9 f/G,a'.�1e'GF.eRLI-t State /OL Zip 32- 33 Phone 3/7 4—qfL -
E-Mail LrinKr-;51-o ,rv1a=1 - eo.,-,--
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company it/edpGle L-L C Qualifying Agent Se��/g^ -k e/Q& &A-
Address 31 p�Z, 441..c� L-a-,-c 47/ City psJ' V4204,- State Al- Zip 71-c Y(
Office Phone 90 V 6?9 7,5-9 3 Job Site Contact Number 76.(7- (x79-3s-8.3
State Certification/Registration# CCC--/..?3/0.5-5-- E-Mail Qri c.- c f Q000L-LC , C.-c.M
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer 'PC-3LA-fl. OR Exempt❑ Expiration Date Z//p2-o24:3'
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
are may be additional restrictions applicable to this property that may be found in the public records of this county,and
$Utt0V: be additional permits required from other governmental entities such as water management districts,state agencies,or
U-1/- .g 5ncies.
OWWR'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all -al/
p amilia laws regulating construction and zoning. o co `)
D 1 ING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
Ci IN YOUR PAYING TWICE FOR IMPROVEMENTS T YOUR PROPERTY. IF YOU INTEND 8
21-g V 1AIN FINANCING, CONSULT WITH YOUR LENDER ORNEY BEFORE Z x C 3
tRIetii: DING •, R NOTICE OF COMMENCEMENT. C0 111 riri
Zii. o
ID
(Signature of Owner or Agent) (Signature of Contractor) 2 .g%
r% _
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)bef me thi dz f V. i
Jiiiiil , 2/jt ,by () ) i ja Net/ , 2 ,by i r
( igS n. u -o ,otary (Signature of otary)
[ ]Personally Known OR )]Personally Known OR
,,Produced Identification [ ]Produced Identification
Type of Identification: ,ci: p Type of Identification:
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 Signature:
*Contractor Name (Print Name): ,..1kP ZM`1 1�I �-�2�t_ ef * //
*Company Name: p o/c- G-L C-
*Mailing Address: 33 /7GJ.�T'h�l �-,,� , t/„t,'}
*City: � (/ �(i`✓�- *State: *Zip Code: 3 2 o
*Telephone Number: L B V" (4/79 3s--g3 *E-mail Address:
Cell Phone Number: 09-5, 5 E ' ( ° `7 Fax Number: 44 6'79 3 (0 ( )
Page 4 of 4 Updated 10/17/18
zi
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
10' !,
*Project Address: /0o7 , '/6- ///✓d ,Cty, /9 TLt �C-H f 3 22-33 Permit#:
*Owner/Project Name: �l s v
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 6—,#P //fl f►-c ,L/o/2
2. Underlayments /4'''"e S`,`44.24 71./0 chOi 2/ 7,5"
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
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No. 172027-5068
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: 41-55 17-2S-29E SELVA LAKES LOT 33
Address of property being improved: 1007 BIG PINE KY Atlantic Beach FL 32233
General description of improvements: Shingle Re-Roof
Owner: KRISTOFF DAVID J Address: 1007 BIG PINE KY Atlantic Beach FL 32233
Owner's interest in site of the improvement: Owner
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 1 Roof LLC
Address: 33 Panther Lane, Suite 4, Pante Vedra, FI, 32081
Telephone No.': (904)679-3583 Fax No: (904)679-3611
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:
-W'/
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in tjegt ,,
713.06(2)(b), Florida Statues. (Fill in at Owner's option) $Pi ! ,
Name: -milk
Address: o
Telephone No: Fax No: r�, P 3 xi
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a differenk`ilote o O
specified): R-+ c z m
WEC
THIS SPACE FOR RECORDER'S USE ONLY OWNER _ ai LI
Signed: Date: II 1 91'i
t4i ;
1019260034,OR 8999 o Before met is C% day of Mt) in the County.f Duv I S -te
)c# O .BK1.,99 Page 879, .—,
ember Pages:1 Of Florida,has personally appeared fj14AX-D 11.4 5-q r-�/
?corded 11/12/2019 08:53 AM, Notary Public at Large,State of Flori4a,CCoynty of Duval.
JNNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: ' 1-Li
JUNTY Personally Known: or
CORDING $10.00 Produced Identification: Y �L 0(_
! r•,/
CITY OF ATLANTIC BEACH BUILDING DEPARTMENT
. _ 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
CERTIFICATE OF COMPLETION
RERF19-0155
REROOF SHINGLE
ISSUED: JOB ADDRESS: REAL ESTATE NUMBER: ZONING:
11/20/2019 1007 BIG PINE KEY 172027 5068
DESCRIPTION OF WORK:
shingle re-roof- FL10124& FL21675
OWNER: CONTRACTOR:
Kristoff David 1 ROOF, LLC
1007 BIG PINE KEY 33 PANTHER LN #4
ATLANTIC BEACH, FL 32233-4363 PONTE VEDRA, FL 32081
APPROVED:
CHIEF BUILDING OFFICIAL
VOID UNLESS SIGNED BY BUILDING OFFICIAL