86 W 2nd St RERF20-0037 Shingle A's REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
RERF20-0037
0 - • ISSUED: 2/27/2020
800 SEMINOLE ROAD
`it 9' ATLANTIC BEACH. FL 32233 EXPIRES: 8/25/2020
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:
86 W 2ND ST REROOF SHINGLE SHINGLE ROOF $3979.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170837 0400 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: R STATE: ZIP:
RELIANT ROOFING INC 4230 Pablo Professional Ct#155 Jacksonville FL 32224
OWNER: ADDRESS: CITY: STATE: ZIP:
BERRY ALICIA ET AL 2009 S WALL ST BELTON TX 76513
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.
rte;
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $70.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$74.00
Issued Date: 2/27/2020 1 of 1
-� y Building Permit Application Updated 10/9/18
` >I� ' City of Atlantic Beach Building Department •*ALL INFORMATION
'`"•' 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
0 1P--- IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 86 West 2nd St Permit Number: GR1c
�07
Legal Description 18-34 17-2S-29E.057 SEC H ATLANTIC BEACH PT LOT 4 RECD O/R 17173-94 RE# 170837-0400
Valuation of Work(Replacement Cost)$3979.00 Heated/Cooled SF Non-Heated/Cooled _
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo OPool OWindow/Door
• Use of existing/proposed structure(s) ❑Commercial ❑Residential
• If an existing structure,is a fire sprinkler system installed??( ❑Yes ONo
• Will tree(s)be removed in association with pr000sedproiect? ❑Yes(rjst submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed: X
reroof townhouse,9 sq.5/12 pitch,shingles FL10124-R21
Florida Product Approval# for multiple products use product approval form
Property Owner InfoatiorFL10124-R21
NameAlicia Berry Address 86 W 2ND STAtlantic Beach FL 32233
City;JACKSONVILLE
State FL Zip 32246 Phone 904-566-1538
E-Mail asberry88@yahoo.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 904-657-0880 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 1.9&.49725 49725 OR Exempt a 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 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 -..•-,i--.c:
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 complCC aU ath5all2020
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.1¢YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOU• *TICE OF COMMENCEMENT.
!, — --
(Signature of s•�ner or Agent) (Signatu,7 : Con fit•
Signed and sworn to(or affirm d)before me thisa5 day of Signed and sworn to(or affirmed)before me thisQday of
es , 1JnA ,by_1r�11 —Z'C1-ki Fed , 9A20, by •vo"1 -,Ig
-
I� _ r��.•..�..i �.. i •. --- � Vii..
AM•NiAlrI ''Ct1(tgrON t 4 • JACKSON
rr,,State of Florida-Notary Public o/ . ,State of Florida-Notary Public
`• •_ Commission*GG 205328 f_-.I -11 •? Commission N GG 205328
My Commission Expires personal) Known OR � • ';.0 MY Commission Expires
Personally K oikj7, ` aP= Y
April 09,2022 April 09,2022
(Produced Ide�tific•' ( ]Produced Identification 'i_.......__._
"tiW. Type of Identification: `, � c,•\\, vP
Type of Identification: A. `�� �YsQS.QY1k YP � �s yCci � � St n
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 3-tab Royal Sovereign FL10124-R21
2. Underlayments GAF Feltbuster FL18686-R1
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: _Q'VL S
*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
Doc # 2020035749, OR BK 19104 Page 2331 , Number Pages : 1 ,
Recorded 02/14/2020 10 : 03 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLiCATE1
Permit No Tax Folio No. fU�
Skate of FIcr:da - County of LIAR).
To whom it may concern:
The undersigned hereby irrfuins you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved 18-34 17-2S-29E .057
SEC H ATLANTIC BEACH
A_LOT 4 RECD O/R 17173-94 BLK 82 -
Address of property being improved )(Q , -and_ S4 . '33
General description of improvements: Roof Replacement
owner Alicia Berry
Address 86 West 2nd Street, Atlantic Beach, FL, 32233
Owners interest in site of the improvement owner _
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Reliant Roofing
Address 4230 Pablo Professional Ct#155 Jacksonville FL 32224
Phone No 904-657-0880 Fax No.
Surely(if any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loon for the constructon of the improvements.
Nome
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated ty 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 ccpy of the Lienor's Notice as provided m
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 dale is one(I)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
402/05/2020
Signed: DATE
Before me this day o r eb__ -_In the
Cew ty of Uuvst.£1 of Florida.hes pers• .-
- ----
i.L� ars ..r. A1NDA JACKSI2I'I
himsellr herself end ertimrx Inman stolen,*
ora trueaadau:uraleo Slats of Florida-Notary
Pubi'
aro aad accurate le Commission A GG 20532 •
1 r• My Commission Expires
April 09.2022
Nor, .Pu cat Large, a cowry or Iligs 71�`
My corn• .Ion enplrQ�; -q- 1-- ,_ _
Of
Porson.
RnA, * A*ntllicatbn \