CITY OF DAYTONA BEACH .PERMITS & LICENSING DIVISION 07 Permit and Licensing Division City of Daytona Beach Post Office Box 311, Daytona Beach, Florida 32115 BUILDING PERMIT APPLICATION Date 6-3-2016 Parcel No. 5322-01-00-0058 Permit No. Job Address 144 LINDLEY ROAD Job Name Owner BARBARA MASON Phone Fax 2014 FBC 5th Edition NEC 2011 Phone (386) 671-8140 Fax (386) 671-8149 Address 144 LINDLEY ROAD _City DAYTONA BEACH State FL Zip 32118 Contractor CBC ROOFING COMPANY Phone 3866779265 Fax NA City _OB State FL. Zip 32173 License No. CCC1328252 Address P.O.B. 731266 Contact Email Address (enter only one) [email protected]Fee Simple Title Holder NA Architect/Engineer NA Address NA Address _£}&_ Improvement Type I [New I lAddition [""[Repair I [Renovation [^Replacement Value of Work: Electrical Plumbing Mechanical Total Value of Work 6.800 Total Sq. Ft. Building Construction Type Description of Work: REROOF CONTRACTOR INFORMATION ELECTRIC CONTRACTOR PLUMBING CONTRACTOR MECHANICAL CONTRACTOR CBC ROOFING COMPANY ROOFING CONTRACTOR SIGN CONTRACTOR POOL CONTRACTOR OTHER CONTRACTOR Occupancy STATE/COUNTY LICENSE NO. CCC1328252 | [Commercial ["•[Residential (Other) Units Floors Flood Zone CONTACT EMAIL CBCROOFING(g>YAHOO.CO
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CITY OF DAYTONA BEACH.PERMITS & LICENSING DIVISION
07
Permit and Licensing DivisionCity of Daytona Beach
Post Office Box 311, Daytona Beach, Florida 32115
BUILDING PERMIT APPLICATION
Date 6-3-2016 Parcel No. 5322-01-00-0058 Permit No.
Job Address 144 LINDLEY ROAD Job Name
Owner BARBARA MASON Phone Fax
2014 FBC 5th Edition
NEC 2011
Phone (386) 671-8140
Fax (386) 671-8149
Address 144 LINDLEY ROAD _City DAYTONA BEACH State FL Zip 32118
Contractor CBC ROOFING COMPANY Phone 3866779265 Fax NA
City _OB State FL. Zip 32173 License No. CCC1328252Address P.O.B. 731266
Contact Email Address (enter only one) [email protected] Simple Title Holder NA
Architect/Engineer NA
Address NA
Address _£}&_
Improvement Type I [New I lAddition [""[Repair I [Renovation [^Replacement
Value ofWork: Electrical Plumbing Mechanical
Total Value of Work 6.800 Total Sq. Ft.Building
Construction TypeDescription ofWork:REROOF
CONTRACTOR INFORMATION
ELECTRIC CONTRACTOR
PLUMBING CONTRACTOR
MECHANICAL CONTRACTOR
CBC ROOFING COMPANY
ROOFING CONTRACTOR
SIGN CONTRACTOR
POOL CONTRACTOR
OTHER CONTRACTOR
Occupancy
STATE/COUNTY LICENSE NO.
CCC1328252
| [Commercial ["•[Residential
(Other)
Units Floors
Flood Zone
CONTACT EMAIL
CBCROOFING(g>YAHOO.CO
ROOFING INFORMATION: Valuation 6800Job Type: Commercial! 1 Residential! | Work Type: New Roof] | Re-roof0 Repair! |
: Total SquaresType ofRoof SHINGLE Sloped Squares 15 FlatSquares***************************************************************************
ELECTRICAL INFORMATION: Valuation
Existing Main ServiceNew Main ServiceService if Increased
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation hascommenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatingconstruction in this jurisdiction.OWNER'S AFFIDAVIT: I certifythat all the foregoing information is accurate and that all work will be done in compliance with allapplicable laws regulating construction and zoning.WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOURPAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BERECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAINFINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OFCOMMENCEMENT.
I hereby affirm that I have complied with the provisions ofChapter 469 ofthe^State Statutes, and I have notified the Dept ofEnvironmentalProtection of my intention to remove asbestos, if applicable^
SIGNATURE OF APPLICANT
State of Florida, County of_Affirmed and subscribed .before me th
Personally known ^_ |_or Produced IdentificationType of Identification Produced
Date £ ' f- tfo
Check one: | |Owner/Builder (must personally appear in office and sign) | |Contractor (license holder)
\MkSht>n -r- , ^\/- \\ Ilis / dayofdli-ru?^ 2Qf& by nU fit INCuMl/JA
1) Job Type: Commercial l~| Residential R 2) Work Type: NewRoofQ Re-Roof R Repair •
3) Roof Deck Type: YT Plywood R V2" OSB |~| 5/8" Plywood f] 5/8" OSB|~| 1"Bv6. 8. 10. 12" IH
Metal |~| Concrete |~| Lightweight Concrete • (other) £]
(Provide information below in"SQUARES" example: 1,200 square feet divided by 100 =12 squares) (1 square=10'x 10')
4) Sloped Area Total Squares 15 + Flat Area Total Squares = Total Squares
Sloped Roof Information Flat Roof Information
Slope 6 /12"Positive Drainage?IfNo, how will it beachieved? ->
• Yes •No
Deck Nailing I | N/A|y | Approx.6" on center Deck Nailing 1 1N/A LJ Approx. 6" on centerSecondaryWater Barrier
(if applicable)
• N/A • Approved Tape0 Peel-N-Stick• See Below
SecondaryWater Barrier
(ifapplicable) EN/A Q Approved TapePeel-N-Stick [_} See Below
Dry In Material/Underlayment
15#Felt Q Peel-N-Stick30# Felt
(Other)
Base
Sheet/UnderlaymentHow Many Layers?
Base
Sheet/Underlayment FLApproval Method orASTM#
Layers of Dry InMaterial
• 1Layer [J N/A2 Layers
Roof CoveringManufacturer
CERTAINTEED Roof CoveringManufacturer
Roof CoveringProduct
LANDMARK/SHINGLERoof Covering Product
Roof Covering FLApproval Method orASTM#
FL5444 Roof Covering FLApproval Method orASTM#
Insured or Appraised (Just) Value of Single Family Site B(Attach Property Appraiser Assessment) $
•uilt Residential Building Structure (ifrequired)
Explain Work: REROOF(Please Print)
It is up to the contractor to use products which comply with the Florida Building Code 5th Edition. Theseproducts include such items as drip edge, flashing, valley material, skylights,vents, fasteners, etc.