88 W 2nd St RERF20-0038 Shingle 51-41:,, REROOF SHINGLE PERMIT PERMIT NUMBER
sr
\s,„....______il" '''' RERF20-0038
CITY OF ATLANTIC BEACH
ovf
v~ 800 SEMINOLE ROAD ISSUED:
"-ri;ti9?' ATLANTIC BEACH. FL 32233 EXPIRES:
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:
88 W 2ND ST REROOF SHINGLE 88 89 W 2nd ST SHINGLE $7404.00
ROOF
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170837 0500 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
RELIANT ROOFING INC 4230 Pablo Professional Ct#155 Jacksonville FL 32224
OWNER: ADDRESS: CITY: STATE: ZIP:
MANGUM W M 13034 TWIN PINES CIR S JACKSONVILLE FL 32246-4148
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $90.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date: 1 of 2
'"`' • �= REROOF SHINGLE PERMIT PERMIT NUMBER
- RERF20-0038
CITY OF ATLANTIC BEACH
7.5.40 at
yr 800 SEMINOLE ROAD ISSUED:
'r n We ATLANTIC BEACH. FL 32233 EXPIRES:
Issued Date: 2 of 2
.,,,i`ry `f` Building Permit Application ,Thdctcvio,".,
.:,,,:- :-,,,,:),,
`.. . 4 City of Atlantic Beach Building Department ALL INFORMATION
, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED. 2
Job Address: 88/90 W.2nd St Permit Number: ` u�" 2.C� ' J
Legal Description 18-34 17-2S-29E.11 SEC H ATLANTIC BEACH PT LOTS 4,5 RECD O/R 10870- RE# 170837-0500
Valuation of Work(Replacement Cost)$7404.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s OCommercial ❑Residential
• If an existing structure,is a fire sprinkler system installed??( ❑Yes ❑No
• Will tree(s)be removed in association with proposed project? ❑Yes(Ast submit separate 1 roe Removal Permit) flNo
Describe in detail the type of work to be performed: X
reroof townhouse, 18 sq, 5/12 pitch,shingles l-L10124-R21
Florida Product Approval# for multiple products use product approval form
Property Owner InrmatiorFL10124-R21
Name David Bolton Address 13034 TWIN PINES CIR S
City JACKSONVILLE _ State FL Zip 37246 Phone 904-880-4637
.
E-Mail bolton79(o,icloud.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'Ft Zip'32224
Office Phone 904-657-0880 Job Site Contact Number 904-712-3111
State Certification/Registration tt CCC1330615 E-Mail amandaareliantroofing.com
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation Insurer Policy#:WC 19649225_..._ OR Exempt 0 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
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies. FF FF C y1
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in complianceL t§al� 5 2020
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY ,1rtment
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. I,F FOU INTEND ;)each, f
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE O_ F COMMENCEMENT.
(Signature of Owner or Agent) (Signat j of Cant . .tor)
Signand sworn to for affirmed)before me thisp2 day of Signed and sworn to(or affirmed)before me this . day of
eb ,202D, by , i g C..t�r Feb 21)2D ,by_ ca 2 IDV) ._ . >,
. e o';
) ',, fel•• DA JACKSON
AMANDA JACKSON ���" state of Florida-Notary Public
�A`r:State of Florida-Notary Public f' r Commission N GG 205328
�., r Commission M GG 205328 ' ", ' M Commission Expires
J Perso !,=:':` OR►Ny Commission Expires [)1/Personally Known OR .,,,,e•,. y
[ ]Prod .. April 09,2022 ( J Produced Identification "'"' April 09,2022
Type of Identifn i�cation 7y'l►giVYtin4xituivo-•_ -- Type of Identification: 0hyS,:60.c 1 evtSV.h k
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: Com/ SL' ..atAw
*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 # 2020030348, OR BK 19097 Page 865 , Number Pages : 1 ,
Recorded 02/07/2020 02 : 37 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT
(PREPARE N DUPLICATE)
Permit No. __ Tax Folio No.
State of Florida County of_D
To whom it may concern:
The uuderstgned hen dry Informs you that improvements will he 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' 1 _� --_gC E •U.
° 1_o-- L .Nee
Address of property being improved: %/i/0 n 9
General description of improvements: Roof Replacement
Owner `ON1( l Sc c\ �
Address_ 1?C,' Twin ¶�tr C 1r c1. 32-2-1-1-(L
Owner's Interest in site of the improvement O\nj nP r
Fee Simple Titleholder(if other than owner)
Name
Address
contractor Reliant Roofing
Address 4230 Pablo Professional Ct#155 Jacksonville FL 32224
Phone No.004-657-0880 Fox No.
Surety(If any)
Address Amount of bend`F _
Phone No, _. Fax No._
Name and address of any person making a loan for the construction of the anprovements
Name
Address
Phone No. Fax No.
Name of person within the Stale of Florida,other than himself,designated ky 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 et Owner's option).
Name
Address .—....__
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration dale is one(1)year from the date of recording unless a
different date is specified): �J
THIS SPACE FOR RECORDER'S USE ONLY iv+
02 /03 12020
Signed: DATE
Before me this daySi_X---"<d)--4, -
Co of Dud L...,t�of l rbrre Fr r personal .,.,....r�' JACKSON
�LL� �1 heAdf�B¢1NDA Public
emsani named and d rmstrvr all statements J 4:-`Il�i• J1d l®te of Flo tar y
era true sod accurate ',15#,: Commission if GG 20632°
/ L2MYC00920Phbos
mmissionNote uo nt ergo,s1 e o county or l)fay i lk
My cemml'Ion rplres: �
Paraonall Rn•
Protium dent cello ._r1, . S1 dim