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1739 Live Oak Ln ROOF20-0062 tile roof permitOWNER:ADDRESS:CITY:STATE:ZIP: CZERKAWSKI JOSEPH J 1739 LIVE OAK LN ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: RELIANT ROOFING INC 4230 Pablo Professional Ct #155 Jacksonville FL 32224 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 172020 0180 SELVA MARINA UNIT 06 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 1739 LIVE OAK LN ROOF NON SHINGLE TILE ROOF $11681.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $110.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $55.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.48 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $169.48 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 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. 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. 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. 1 of 2Issued Date: 10/16/2020 PERMIT NUMBER ROOF20-0062 ISSUED: 10/16/2020 EXPIRES: 4/14/2021 ROOF NON SHINGLE PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 2 of 2Issued Date: 10/16/2020 PERMIT NUMBER ROOF20-0062 ISSUED: 10/16/2020 EXPIRES: 4/14/2021 ROOF NON SHINGLE PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 Final Plumbing Final Electrical Final HVAC CC Final Final Building* Swimming Pool Steel Swimming Pool Safety Electrical Grounding & Bonding Swimming Pool Final (Bldg) Swimming Pool Final (PW) Formed Columns/ Beams* Masonry Cell Fill Structural Steel* OTHER: OTHER: OTHER: OTHER: OTHER: Power Pole Silt Fence Piers/ Stem Walls Underground Plumbing Underground Electric Foundation/ Footing Slab** Retaining Wall Footing Driveway Sewer (Building Dept) Sewer Tap (Utilities Dept) Rough Electric* Rough Plumbing/ Top Out* Rough Mechanical* House Wrap Wall Sheathing Roof Sheathing Tie-down Framing Connections Rough Framing Roofing In Progress Window/Door In-Progress Insulation Ceiling Insulation Wall Exterior Lath Stucco Scratch Coat Exterior Siding In-Progress Brick Flashing & Ties Early Power Gas Rough Gas Final* * When all rough electric, plumbing, mechanical are complete but before any work is covered up. * When all gas piping is complete and wallboard is installed but before gas is attached to any appliance. All outlets must be capped and pipe pressurized at a minimum of 15 lbs. * For new living space: When all construction work including electrical, plumbing, mechanical, exterior finish, grading, required paving and landscaping is complete and the building is ready for occupancy, but before being occupied Additional inspections may apply to your project if your project contains these elements: INSPECTIONS REQUIRED FOR BUILDING PERMITS To verify compliance with building codes, inspections of the work authorized are required at various points of the construction. The following inspections are typically required for residential projects: Date: Initial: Date: Initial: _____________________________________________________ Permit Type ____________________________________________________ Permit No. __________________________________________________________ Job Address ____________________________________________________ Contractor POST THIS CARD WITH PERMITS AND PERMIT DOCUMENTATION IN FRONT OF BUILDING Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends Building Department Public Works/Utilities Fire Department Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789 Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203 * When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all electrical, plumbing and mechanical work is in place, but before concrete is poured. * When all structural steel members are in place and all connections are complete, but before such work is covered or concealed. ** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION ROOF20-0062 1 The following guidelines are provided for the installation of Boral TileSeal®, however local building codes may differ so please consult with the local building department for any different or additional installation requirements. GENERAL GUIDELINES FOR ALL INSTALLATIONS The deck must be clean, dry, free from loose contaminants, and structurally sound. Boral TileSeal should be installed when ambient and substrate temperatures are 40F (4.4C) or higher. For tile applications (i) do not use Boral TileSeal below a 2½:12 (21% slope) when tiles are mechanically fastened and (ii) do not use Boral TileSeal below 2:12 (17% slope) when using foam adhesive to fasten tiles. Water must be allowed to drain freely from all areas of the roof. For tile applications outside the High Velocity Hurricane Zone of Florida, Boral TileSeal should be installed in compliance with local building codes and the applicable Tile Installation Manual published by the Tile Roofing Institute. For tile applications in the High Velocity Hurricane Zone of Florida, Boral TileSeal must be installed in accordance with Miami-Dade building codes. Roof tiles may be loaded directly onto Boral TileSeal underlayment up to 6:12 roof pitch. Loading boards or battens are required on roof pitches greater than 6:12. When using tile fasteners with Boral TileSeal, the use of modified mastic is optional because Boral TileSeal is a self- sealing underlayment based on testing performed pursuant to ASTM D 1970. When installing higher profile tiles with a closed tile valley detail, it may be necessary to consider the potential exposure of the Boral TileSeal underlayment in regions where the valley metal is installed first. While it may take extended time periods for the surface mat to show any signs of degradation due to partial exposure to UV rays, it should be noted that in most cases where a double weave of the valley has been used, there will still be plenty of protection from the SBS modified base material. In the interests of good roofing practice, a narrow strip of an approved granular surface modified type cap sheet may be applied in the valley center prior to the tile installation. Some codes require an additional base sheet under Boral TileSeal. Check your local building codes. INSTALLATION INSTRUCTIONS Boral TileSeal® HT INSTALLATION GUIDELINES Boral Roofing Build something great™ 2-PLY OR MULTI-PLY SYSTEMS WITH A BASE SHEET Install a code approved base sheet onto the entire roof surface according to local code and manufacturer’s instructions. Apply the metal drip edge and other flashings over the base sheet. Coat entire metal surface of deck flange with asphalt primer. Apply Boral TileSeal to the roof, starting at the eave. The first course of Boral TileSeal should be parallel and flush to the edge of the eave. Fasten the top of each sheet to the deck through the black selvage lap maximum 12” on center with approved fasteners. Apply each succeeding course of Boral TileSeal, lapping the entire width of the black selvage area. Apply SBS mastic under all laps onto the top white surface of Boral TileSeal. (Pic 1) All end laps must be minimum 6”. Use a roller to insure complete adhesion to the base sheet. (Pic. 2) 1 2 SINGLE PLY (DIRECT TO DECK) Boral TileSeal may be self-adhered to primed or unprimed plywood, primed or unprimed oriented strand board (OSB), Huber ZIP System® Roof Sheathing, or DensDeck® Prime Roof Boards. Primer must conform to ASTM D 41 and primer manufacturer’s installation instructions must be followed. If an additional sheet is not used under Boral TileSeal, use a separator/slip sheet between metal and deck where required by code, and coat the roof flange as described above. Install Boral TileSeal in all valleys by either weaving or by first applying a strip down the length of the valleys as shown below. When weaving the underlayment in the valleys, the upper edge of the underlayment must be at least 12” past the center of the valley. See Vallley Options section. Apply Boral TileSeal to the roof, starting at the eave. The first course of Boral TileSeal should be parallel and flush to the edge of the eave. Use a roller to insure complete adhesion to the roof deck. (Pic. 2) 2Boral TileSeal® Installation Guide Fasten the black selvage area at the top of the sheet at 12” on center. (Pic. 3) Apply each succeeding course of Boral TileSeal, lapping the entire width of the black selvage area. 3 It is necessary to seal all end laps using one of the following methods: The first is to apply SBS modified mastic under all laps and onto the top white surface of Boral TileSeal to ensure a completely watertight seal. All laps must be minimum 6”. Alternatively, an Inverted Sheet Seam may be made by adhering the ends onto an inverted sheet that has been fastened to the roof deck. Inverted Sheet Seam (not allowed in Hurricane Zones) Cut a 12” strip of Boral TileSeal® and invert (flip over) on the roof deck in a position that half will be under the end of the adjoining sheets. Tack the strip into place before setting the sheets. (Pic. 4) 4 Lap the adjoining sheets onto the inverted strip and press the sheets together to form a solid bond. Roll the seams with a seam roller to assure complete adhesion. (Pic. 5) 5 Completed Inverted Sheet Seam (Pic.6) 6 Valley Option 1 ROOF DECK UNDERLAYMENT WOVEN TO EXTEND THROUGH VALLEY LINE A MINIMUM OF 12” SINGLE LAYER FELT Valley Option 2 ROOF DECK ROOF DECK VALLEY FLASHING UNDERLAYMENT TO LAP OVER VALLEY METAL A MINIMUM OF 2” VALLEY FLASHING (EXTEND ENTIRE WIDTH OF VALLEY METAL BEYOND ROOF DECK) OPTIONAL: SELF-ADHERING POLYMER MODIFIED ASPHALT MEMBRANE ON EACH SIDE TO COVER FLASHING FLANGE CUT TOP CORNER OF UNDERLAYMENT TO INSURE PROPER DIVERSION OF WATER INTO THE VALLEY METAL 36” SWEAT/BLEEDER SHEET ROOF UNDERLAYMENT Boral TileSeal® HT © 2019 Boral Roofing LLC Rev-2/19800.669.8453 | BoralRoof.com BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts Publications Contact Us BCIS Site Map Links Search Product Approval USER: Public User Product Approval Menu > Product or Application Search > Application List > Application Detail FL #FL14317-R10 Application Type Revision Code Version 2017 Application Status Pending FBC Approval Comments Archived Product Manufacturer Boral Roofing / MonierLifetile Address/Phone/Email 7575 Irvine Center Drive Suite 100 Irvine, CA 92618 (602) 269-2288 Ext 8320 thomas.jemmett@boral.com Authorized Signature Thomas Jemmett thomas.jemmett@boral.com Technical Representative Adrian Cooper Address/Phone/Email 135 NW 20th Street Boca Raton, FL 33431 (954) 520-5461 acoopeer@minierlifetile.com Quality Assurance Representative Address/Phone/Email Category Roofing Subcategory Underlayments Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed the Evaluation Report Robert J. M. Nieminen Florida License PE-59166 Quality Assurance Entity UL LLC Quality Assurance Contract Expiration Date 08/21/2020 Validated By John W. Knezevich, PE Validation Checklist - Hardcopy Received Certificate of Independence FL14317_R10_COI_2018_01_COI_NIEMINEN.pdf Referenced Standard and Year (of Standard)Standard Year ASTM D1970 2015 FRSA/TRI (April 2012) 04-12 2012 UL 1897 2012 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 10/12/2018 Date Validated 10/15/2018 Date Pending FBC Approval 10/22/2018 Summary of Products FL #Model, Number or Name Description 14317.1 Boral Roof Underlayments Roof underlayments for use in prepared roof assemblies Limits of Use Approved for use in HVHZ: No Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: +N/A/-210 Other: 1.) The design pressure in this application pertains to a particular underlayment system for use under foam-on tile systems. Refer to ER Section 5.6.4. 2.) Refer to ER Section 5 for Limits of Use. Installation Instructions FL14317_R10_II_2018_10_FINAL_ER_BORAL_Underlayments_FL14317- R10.pdf Verified By: Robert J. M. Nieminen PE - 59166 Created by Independent Third Party: Yes Evaluation Reports FL14317_R10_AE_2018_10_FINAL_ER_BORAL_Underlayments_FL14317- R10.pdf Created by Independent Third Party: Yes Back Next Contact Us :: 2601 Blair Stone Road, Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida is an AA/EEO employer. Copyright 2007-2013 State of Florida. :: Privacy Statement :: Accessibility Statement :: Refund Statement Under Florida law, email addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. To determine if you are a licensee under Chapter 455, F.S., please click here . Product Approval Accepts: EXTERIOR RESEARCH & DESIGN, LLC. Certificate of Authorization #9503 353 CHRISTIAN STREET, UNIT #13 OXFORD, CT 06478 (203) 262-9245 EVALUATION REPORT Eagle Roofing Products Florida LLC. 1575 East Country Road 470 Sumterville, FL 33585 (800) 400-3245 Evaluation Report E1322.09.06-R5 FL7473-R8 Date of Issuance: 02/24/2009 Revision 5: 10/16/2017 SCOPE: This Evaluation Report is issued under Rule 61G20-3 and the applicable rules and regulations governing the use of construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen, P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The products described herein have been evaluated for compliance with the 6th Edition (2017) Florida Building Code (NON-HVHZ) sections noted herein. DESCRIPTION: Eagle Roof Tiles LABELING: Labeling shall be in accordance with the requirements the Accredited Quality Assurance Agency noted herein. CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product changes or the referenced Quality Assurance documentation changes. Trinity|ERD requires a complete review of this Evaluation Report relative to updated Code requirements with each Code Cycle. ADVERTISEMENT: The Evaluation Report number preceded by the words “Evaluated by Robert Nieminen, P.E.” may be displayed in advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety. INSPECTION: Upon request, a copy of this entire Evaluation Report shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This Evaluation Report consists of pages 1 through 5. Prepared by: Robert J.M. Nieminen, P.E. Florida Registration No. 59166, Florida DCA ANE1983 The facsimile seal appearing was authorized by Robert Nieminen, P.E. on 10/16/2017. This does not serve as an electronically signed document. Signed, sealed hardcopies have been transmitted to the Product Approval Administrator and to the named client CERTIFICATION OF INDEPENDENCE: 1. Trinity|ERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or distributing products it evaluates. 2. Trinity|ERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates. 3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest in any company manufacturing or distributing products for which the evaluation reports are being issued. 4. Robert Nieminen, P.E. does not have, nor will acquire, a financial interest in any other entity involved in the approval proc ess of the product. 5. This is a building code evaluation. Neither Trinity|ERD nor Robert Nieminen, P.E. are, in any way, the Designer of Record for any project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless r etained specifically for that purpose. Exterior Research and Design, LLC. 6TH EDITION (2017) FBC NON-HVHZ EVALUATION Evaluation Report E1322.09.06-R5 Certificate of Authorization #9503 Eagle Roofing Products Florida LLC.; (800) 400-3245 FL7473-R8 Revision 5: 10/16/2017 Page 2 of 5 ROOFING SYSTEM EVALUATION: 1. SCOPE: Product Category: Roofing Sub-Category: Roofing Tiles Compliance Statement: Eagle Roof Tiles, as produced by Eagle Roofing Products Florida LLC, have demonstrated compliance with the following sections of the 6th Edition (2017) Florida Building Code (NON-HVHZ) through testing in accordance with the following Standards. Compliance is subject to the Installation Requirements and Limitations / Conditions of Use set forth herein. 2. STANDARDS: Section Property Standard Year 1507.3.5, R905.3.5 Physical Properties ASTM C1492 2003(2009) 1507.3.7, R905.3.7 Attachment Requirements FRSA/TRI April 2012 (04-12) 2012 1504.2.1.1 Overturning Moment SSTD 11 1997 3. REFERENCES: Entity Examination Reference Date ATL (TST 3782) ASTM C1492 RT0310.01-17, 02-17, 03-17 03/15/2017 ATL (TST 3782) ASTM C1492 – Freeze/thaw RT0706.01-17, 02-17, 03-17 09/25/2017 Tile Roof Institute SSTD 11 Membership Letter 11/29/2005 ATI (QUA 1844) Quality Assurance Inspection Report 06/07/2017 4. PRODUCT DESCRIPTION: 4.1 ASTM C1492, Type III (Low Profile): BEL AIR Exterior Research and Design, LLC. 6TH EDITION (2017) FBC NON-HVHZ EVALUATION Evaluation Report E1322.09.06-R5 Certificate of Authorization #9503 Eagle Roofing Products Florida LLC.; (800) 400-3245 FL7473-R8 Revision 5: 10/16/2017 Page 3 of 5 4.2 ASTM C1492, Type II (Medium Profile): MALIBU 4.3 ASTM C1492, Type I (High Profile): CAPISTRANO 5. LIMITATIONS: 5.1 This is a building code evaluation. Neither Trinity|ERD nor Robert Nieminen, P.E. are, in any way, the Designer of Record for any project on which this Evaluation Report, or previous versions thereof, is/was used for permitting or design guidance unless retained specifically for that purpose. 5.2 This Evaluation Report is not for use in FBC HVHZ jurisdictions. 5.3 Fire classification is not part of this evaluation; refer to FBC 1505.2, Exception 2 (for non-combustible deck) or listing by an approved testing agency for fire rating of this product. 5.4 Underlayment shall be that which holds Florida Product Approval for use with tile roofing systems. The underlayment Product Approval shall specify allowable method(s) of tile installation (mec hanical attachment, mortar-set and/or adhesive-set) for use with the specific underlayment. For mortar-set or adhesive-set tile roofing applications, the underlayment Product Approval shall specify attachment methods for the underlayment system to resist wind uplift design loads in accordance with Table 1A of FRSA/TRI April 2012 (04-12). 5.5 ”Color-Bonded” or “Slurry-Coated” files are limited to use on projects in areas subjected to weathering indices of 50 or less (negligible weathering), as outlined in Figure 1 of ASTM C1492-03(2009)i, reproduced below for reference. This limitation does not apply to the “Color-Through” product offering. 5.6 All products in the roof assembly shall have quality assurance audit in accordance with FAC Rule 61G20-3. Exterior Research and Design, LLC. 6TH EDITION (2017) FBC NON-HVHZ EVALUATION Evaluation Report E1322.09.06-R5 Certificate of Authorization #9503 Eagle Roofing Products Florida LLC.; (800) 400-3245 FL7473-R8 Revision 5: 10/16/2017 Page 4 of 5 6. INSTALLATION: 6.1 Eagle Roof Tiles may be mechanically fastened, mortar-set or adhesive-set. Installation shall comply with manufacturer’s current published instructions, but not less than the requirements of FBC 1507.3 and the FRSA/TRI Florida High Wind Concrete and Clay Tile Installation Manual. 6.2 Underlayment shall be installed in accordance with FRSA/TRI April 2012 (04-12) or the underlayment manufacturer’s current Product Approval. For mortar-set or adhesive-set tile roofing applications, the underlayment current Product Approval shall specify attachment methods for the underlayment system to resist wind uplift design loads in accordance with Table 1A of FRSA/TRI April 2012 (04-12). 6.3 Tile Attachment: 6.3.1 Mechanically Attached Tile: Wind load resistance shall be in accordance with Table 3 of FRSA/TRI April 2012 (04 -12) to resist the Uplift Moment determined in Table 2A or 2B of FRSA/TRI April 2012 (04-12) or FBC 1609.5.3. 6.3.2 Mortar-Set Tile: Wind load resistance shall be in accordance with Table 2A or 2B of FRSA/TRI April 2012 (04-12) or FBC 1609.5.3 in conjunction with the mortar manufacturer’s Product Approval. 6.3.3 Adhesive-Set Tile: Wind load resistance shall be in accordance with Table 2A or 2B of FRSA/TRI April 2012 (04-12) or FBC 1609.5.3 in conjunction with the adhesive manufacturer’s current Product Approval. Refer to the current version of the referenced Florida Product Approval for paddy-placement details and performance data. TILE ADHESIVES FOR ADHESIVE-SET TILE SYSTEMS Manufacturer Product(s) Florida Product Approval DAP Foam, Inc. “Touch N’ Seal Storm Bond” FL14506 “Touch N’ Seal Storm Bond 2” FL21374 Dow Chemical “TILE BOND™” FL22525 ICP Adhesives & Sealants, Inc. “Polyset® AH-160” FL6332 “Polyset® RTA-1” FL6276 6.3.4 Hip and Ridge Tile: Tile shall be installed in accordance with FRSA/TRI April 2012 (04-12). For hip and ridge tile installations atop hip and ridge metal, refer to the hip and ridge metal manufacturer’s current Product Approval (e.g., FL5374) or test report in accordance with SSTD 11 for allowable loads to resist those determined in accordance with Table 1A of FRSA/TRI April 2012 (04-12). Exterior Research and Design, LLC. 6TH EDITION (2017) FBC NON-HVHZ EVALUATION Evaluation Report E1322.09.06-R5 Certificate of Authorization #9503 Eagle Roofing Products Florida LLC.; (800) 400-3245 FL7473-R8 Revision 5: 10/16/2017 Page 5 of 5 7. LABELING: 7.1 Each unit shall bear the imprint or identifiable marking of the manufacturer’s name or logo . Tile lots shall be labeled in accordance with the requirements of the Accredited Quality Assurance Agency noted herein. 7.2 Tile not tested for freeze-thaw shall state clearly that the lot has not been tested for freeze-thaw acceptance on all lot tags or certification. 8. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of this product. 9. MANUFACTURING PLANTS: Sumterville, FL 10. QUALITY ASSURANCE ENTITY: Architectural Testing, Inc. – QUA1844; (717) 764-7700 - END OF EVALUATION REPORT - i ASTM C1492-03, Standard Specification for Concrete Roof Tile, © ASTM International DESCRIPTION ACCOUNT QTY PAID PermitTRAK $169.48 ROOF20-0062 Address: 1739 LIVE OAK LN APN: 172020 0180 $169.48 BUILDING $110.00 BUILDING PERMIT 455-0000-322-1000 0 $110.00 BUILDING PLAN REVIEW $55.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $55.00 STATE SURCHARGES $4.48 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.48 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R13831 $169.48 Printed: Friday, October 16, 2020 3:28 PM Date Paid: Friday, October 16, 2020 Paid By: Cameron Shouppe Pay Method: CREDIT CARD 386932889 1 of 1 Cashier: JJ Cash Register Receipt City of Atlantic Beach Receipt Number R13831