1737 W Park Ter RERF20-0020 Shingle % -;:: %f," REROOF SHINGLE PERMIT PERMIT NUMBER
i: CITY OF ATLANTIC BEACH RERF20-0020
��- �� ISSUED: 2/5/2020
800 IC BEA LE ROAD
��3��� EXPIRES: 8/3/2020
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:
1737 W PARK TER REROOF SHINGLE SHINGLE ROOF $24706.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0374 SELVA MARINA UNIT 08
COMPANY: ADDRESS: CITY: STATE: ZIP:
RELIANT ROOFING INC 4230 Pablo Professional Ct#155 Jacksonville FL 32224
OWNER: ADDRESS: CITY: ! STATE: ZIP:
BUSH LAURIE B TRUST 1737 PARK TER W 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $175.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.63
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $179.63
Issued Date: 2/5/2020 1 of 1
.,,o Building Permit Application Updated 10/9/18
`1r City of Atlantic Beach Building Department ;�`r sat{ rk a ,.;
.L' 800 Seminole Road, Atlantic Beach, FL 32233 ,
Phone: (904) 247-5826 Email: Building-Dept@coab.us ;`:1L `! I: tt.i.`Aa
Job Address: 1737 Park Terrace W ' `Permit Number: -R 'z 0-cc:, z
Legal Description 34-85 09-2S-29E SELVA MARINA UNIT 8 LOT 18 BLK 12 RE# 172020-0374
Valuation of Work(Replacement Cost)$24706.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ONew ❑Addition XAlteration ❑Repair ❑Move ODemo OPool ❑ caw Deorr 1 ,
,' d
• Use of existing/proposed structure(s): DCommercial IZResidential ED• If an existing structure,is a fire sprinkler system installed?: OYes MNo
• Will trees be removed in association with proposed prosect?C�Yy;lmust submit se?crate:Tr!!Rert Pe i :inw ......
Y ` tl:( 1 ; .' :�Yp.e of•work to be performed:
tt
• reroof,49 sq,4/12 pitch,shingles FL10124-R21
Florida Product Approval# FL10124 R21for multiple pr?odducts use product approval form __•.
Property Owner Information
Name LAURIE BUSH Address 1737 PARK TER W
Atlantic Beach -,_-.-:- -.... .. ... -.
Cityj State FL zip 32233 Phone 904-571M189
E-Mail Laurieofb@gmail.com
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;FI Zip 32224
Office Phone 904-§57-058QJob Site Contact Number 904-712-3111
State Certification/Registration# CCC1330615 E-Mail amandaarelian(roofinq.com , . -
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer I Pplicy#-WC 196-49725.__.• OR Exempt FI, 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 addition to the•regtifrerne •, , i
perrrlit there mat'tie additional restrictions applicable to this property that may be found in the public records of tlhis cotlrtt,r
Oere may)e-,addigc,mpl permits required from other governmental entities such as water management;distr]cts,,Atete'�age i a_
cieral age[lties.
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 YOUR NOTICE OF COMMENCEMENT. _--.
6 ,,. /.�//�.
(Signature of Owner or Agent) ';"ure of ye'"ctor) v
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirm•.)before me this 30 day of
341aD,by I. . . -AN , acro,b a 4.. . - •. •
ii..,• • 09111411!.......,......s....:- 1.. £,:....1►"�!':, ..L•11,
,4h�natur� v 'DA JACKS-ON .r.T
o � "Y bA JACKSON
+o`'� State of Florida-Notary Public ZI State of Florida-Notary Public
'.�1•= Commission MGG 205328 �'.= Commission I GG 205328
Personally Known OR :�"' , = My Commission Expire
s l .ersonaily Known OR 7%1:, " '�"` My Commission Expires
',,,!;,;..''� April 09,2022 ''",7,-. ,". April 09,2022
( ]Produced Identification rnduced Identification
Type of Identification: rip. • •' 4 •,.• - :_ _ _ Type of Identification: 1 1 'MOM 11t+tta llOIYIVAI allXi __
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of r›.,0/0-1
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 d ,-31-)`-/
scription of propsr being improved: 7^' U-)Ct as act EvU,, Iv`anr o utAi} $ 1 ZLl( ►2
Address of property being improved: (13 7 Pi.,r k rr' t P \lu 37233
General description of improvements: Roof Replacement
Owner LQ c\'e _ tA.sh
Address � • • s `L 2'�
Owner's interest in site of the improvement (-Aux-ve
Fee Simple Titleholder(if other than owner) _
Name
Address
_ ,n contractor Reliant Roofing
✓�i� Address 4230 Pablo Professional Ct#155 Jacksonville FL 32224
Phone No.904-657-0880 Fax No.
1
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,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,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 Owners 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
Signed: • . • iropL DATE I-Or-102.0
Doc#2020024568,OR BK 19089 Page 790, Before me this day of_:2?:
FY-72,,C/2_17-77-1 me
Number Pages:1 co nty.Duval, tate of ride. .• :nq•" • of Florida-Notary Public
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL are true and accu .to 'j..1911"4 ? Commission•GG 2053213
COUNTY �: ' t
My
Commission Expiros
RECORDING $10.00 ! It %''«rr�•
,.•`�
Notary0
Pubt, •Large.State of IS . Count)of ti,'Rram1
My comm expires' •it31leTi .r► Apri108,2022
Persona n • �er4Wi� or
Produc-• •: tilcahon 1
4
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
*Project Address: 1737 Park Terrace W Permit#:
*Owner/Project Name: 1737 Park Terrace W
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
I 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
-71
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 GAF Timberline HD Architectural FL10124-R21
2. Underlayments GAF Weatherwatch FL5259-R2
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#
1 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.
*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
nJS f, Permit Inspections
City of Atlantic Beach
Permit Number: RERF20-0020 Description:SHINGLE ROOF
Applied:2/3/2020 Approved:2/3/2020 Site Address: 1737 W PARK TER
Issued: 2/5/2020 Finaled: 2/11/2020 City,State Zip Code:Atlantic Beach,Fl 32233
Status: FINALED Applicant: <NONE>
Parent Permit: Owner: BUSH LAURIE B TRUST
Parent Project: Contractor: <NONE>
Details:
LIST OF INSPECTIONS
SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS
ID
ROOF FINAL** Mike Jones
Notes:
2/6/2020 2/6/2020 ROOF DRY IN Rick Bell PASSED
Notes:
Hector:735-8303
8:OOA
2/11/2020 M 2/11/2020 ROOF FINAL** Rick Bell PASSED Hector 904-735-8303
Notes:
Printed: Wednesday, 12 February, 2020 1 of 1 •
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