710 Triton Rd RERF19-0178 Shingle 70.-m--:,),,,,,
),01=m-:, REROOF SHINGLE PERMIT PERMIT NUMBER
'k 196:112708
_� CITY OF ATLANTIC BEACH ISSUED: 12/ 1/2019
800 SEMINOLE ROAD
1-_ • ATLANTIC BEACH. FL 32233 EXPIRERERFS: 20
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:
710 Triton Rd REROOF SHINGLE shingle re-roof FL10124 $8994.00
TYPE OF REAL ESTATE I ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171339 0000
COMPANY: ADDRESS: CITY: STATE: ZIP:
RELIANT ROOFING INC 4230 Pablo Professional Ct #155 Jacksonville FL 32224
OWNER: ADDRESS: 1 CITY: STATE: ZIP:
COOK AUSTIN M 710 TRITON RD ATLANTIC BEACH 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.
u4
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
I 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: 12/11/2019 1 of 2
0I.A „, REROOF SHINGLE PERMIT PERMIT NUMBER
:3 #411hstA� RERF19-0178
aCITY OF ATLANTIC BEACH
5 v 800 SEMINOLE ROAD ISSUED: 12/11/2019
-- 'i ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2020
I
Issued Date: 12/11/2019 2 of 2
- .4 Building Permit Application Updated 10/9/18
" s City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`Uf1IS REQUIRED
Phone: (904) 247-5826 Email: Building-Dept@coab.us r
Job Address:7.10 Triton Rd Permit Number: �Li_P t q -a
Legal Description .31-1 17-2S-29E ROYAL PALMS UNIT 2 A LOT 21'BLK 14. RE# 171339-0000. !`; •
Valuation of Work(Replacement Cost)$8994.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ONew OAddition ❑Alteration ORepair OMove ODemo ❑Pool OWindow/Door
• Use of existing/proposed structure(s): ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ONo
• Will trees)be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) CINo
Describe in detail the type.of work.to be performed:
reroof, 15 sq,'2/12p(tchj, -,� R 2,1 S v{��i►�3‘-es.
Florida Product Approval# rL I O I Z 14_ r�2 ) - for multiple products use product approval form
Property Owner Information
Name Austin'Cook Address 710.TRITONRD
City!Atlantic Beach. State FL Zip 32233 ' Phone 904;625.8525
E-Mail :jaxcookpii meal oo
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Reliant Roofing Qualifying Agent Cameron Shouppe
Address 4230 Pablo Professional Ct#155 City; Jacksonville State'Fl Zipj 32224
Office Phone 904-657-0880 Job Site Contact Number 904-712-3111
State Certification/Registration# CCC1330615 E-Mail amanda@reliantroofing.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer:Policy#:WC 196-49725..._.. _OR Exempt h Expiration Date 11/20/2020
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 add{tioki to the raquirernents of this
permit,there maybe 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
fedei a l 8getteies,
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in co�rtigncg y3th all
applicable laws regulating construction and zoning. Uu ((;; I U
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
RECO' i ':SYOLUR NOTICE OF COMMENCEMENT.
eociie4 b9re of Owner or Agent) .tur/Contractor)
Signed and sworn ttoior affirm d)before me this 10 day of Signed and sworn o or affirmed)before me this ID day of
(Signature of N tary) (signature of N•tart')
AMANDA JACKSON
��1/// , ;e•.�e,, AMANDA JACKSON grate of Florida-Notary Public
Personally Known OR ° .1, r;t_State of Florida-Notary Public personally Known OR • fi_ Commission M GG 205328
]Produced Identification = Commission 0 GG 205328 )Produced Identification y:;.:, :rtc My Commission Expires
�ti; ac
Type of Identification: ;;� ,.dc My Commission Expires --I pe of Identifications "• � A•rli09,2022
Apri109,2022
Doc # 2019267617, OR BK 19010 Page 1552, Number Pages: 1,
Recorded 11/20/2019 09:39 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10. 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No._
State of County of pv.VQLI
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following Information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 31-1 17-2S-29E ROYAL PALMS UNIT 2 A
LOT 21 BLK 14
Address of property being improved: ! 10 *nn - 2233
General description of improvements: £-r00
Owner Austin Cook
Address 710 TRITON RD Atlantic Beach FL 32233
Owner's interest in site of the improvement Owner
Fee Simple Titleholder(If other than owner) _
Name
Address
Contractor Reliant Roofing
Address 4230 Pablo Professional Ct 155 JAX FL 32224
Phone No. 9046570880 Fax No.
Surety(If any)
Address Amount of bond$
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 expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
rCL7wGd
DATE 116/019S9r
Before me this it day at'=J�f p�._.�S,Z��__ in the
•= of• vol.State• Son•a has personally:••ear • .
a JACKSON
h+msei herselfandaffkmsthatlits
=nts' �'t•� "' DA Public. '
are Irue and accurate •o State of Floride-Noter0
�'�•= Commission p G f,2053e e
i •.ri�A My Commission Exp'
AOril09.2022.
Not: d tLr•-•Stateof .Counryof lEIVIL
My comm- •n e •res._ •— •
Personally or
Produced I• cation
Category/Subcategory o Manufacturer Product Description g rY 1--Limitation of Use State# Local#
C. PANEL WALL
1.Siding
2.Soffits
3. EI FS
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 GR 'ri 'dine HD rFL1012/4-na 1
2. Underlayments GAr C 1-t-},uSt-er FL 1 g(('k--R
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
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):Cameron Shouppe *Contractor Signature: - -
*Company Name: Reliant Roofing
*Mailing Address: 4230 Pablo Professional Ct #155
*City: Jacksonville *State: FL *Zip Code: 32224
*Telephone Number: 9046570880 *E-mail Address: amanda@reliantroofing.com
Cell Phone Number: 9047123111 Fax Number:
Page 4 of 4 Updated 10/17/18