1079 Atlantic Blvd ROOF19-0056 TPO Re-Roof ''f� ROOF NON SHINGLE PERMIT PERMIT NUMBER
r. ` ROOF19-0056
CITY OF ATLANTIC BEACH ISSUED: 7/1/2019
800 SEMINOLE ROAD
+� 19~ ATLANTIC BEACH. FL 32233 EXPIRES: 12/28/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' ! ` 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:
1079 ATLANTIC BLVD ROOF NON SHINGLE TPO re-roof- 41 squares $37476.00
TYPE OF •
ZONING: : r •
• • GROUP:
177416 0000 SECTION LAND
. • ®� ADDRESS: CITY: STATE: ZIP:
STONEBRIDGE 6956 PHILLIPS PARKWAY DR N JACKSONVILLE FL 32258
CONSTRUCTION
• err • CITY
SOLOMON PROPERTIES 14255 BEACH BLVD JACKSONVILLE FL 32250
INC
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.
mrLIST OF • r •
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $240.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $120.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.40
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.60
TOTAL: $369.00
Issued Date: 7/1/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
t " Atlantic Beach, Florida 32233-5445 l
s
Phone(904)247-5826 - Fax(904)247-5845 I� �•
> E-mail: building-dept@coab.us Date routed: �J 0
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: L�� ( (_ UC' Department review required Ye No
r,, /�,\ Building,_.,..
Applicant: Sfi�b(1 �,�SuclYl Planning &Zoning
Tree Administrator
Project: ZPD f t -f oop L{ l 'S%q.CVeA Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: FApproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
CBUILDIND
PLANNING &ZONING /M '• /•� !''
Reviewed by: f� ' ' Date:
41
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑D ied. []Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. []Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Applicati �W12/8/,7
' City of Atlantic Beach
VFFICE COPY
r./ 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 //�� q
Job Address: 1079 Atlantic Blvd Atlantic Beach, FL 32233 Permit Number: ?–Oop I l o osto
Lega I Description 10-820-2S-29E 255 SALTAiR SEC 1 LOTS 751.752 771,W 3FT LOT 772(EX PT RECD O/R 9430-138 PARCEL 6) RE# 170656-0000
Valuation of Work(Replacement Cost)$ 37,476.00 Heated/Cooled SF 4096 Non-Heated/Cooled 412
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
Roof Replacement 41 sq Flat pitch using GAF TPO
Florida Product Approval#_FL5293 for multiple products use product approval form
Property Owner Information
Name, _Solomon Properties Inc Address: 14255 Beach Blvd
City Jacksonvile Beach State FL Zip 32250 Phone 1` Z'3`I)-sstl
E-Mail 1 i_-Ire)USIf1C_� Lt C`t (_orn
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Stonebridge Construction Services LLC Qualifying Agent: Brian Vick
Address 6956 Philips Parkway Dr N _city Jacksonville State FL Zip 32256
Office Phone 904-262-6636 _ Job Site/Contact Number Chris Reagan /904-463-8217
State Certification/Registration# CM 328917 E-Mail jennifer@stonebridgebullt.com N
Architect Name&Phone# �i p
Engineer's Name&Phone# —< 0 H
Workers Compensation Bridgefield Casualty Ins Co 05/16/20 F= ui
Exempt/Insurer/Lease Employees/Expiration Date ( Q 0
Application is hereby made to obtain a permit to do the work and installations as indicated, I certify that no work or installation h� Q V Q
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationgs CC Z
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIG LLO Q
WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS, and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements 90 N H
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county ng Z
W
there may be additional permits required from other governmental entities such as water management districts,state agencies,oi- pC 2
federal agencies. - a UJI
CC M
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with o ~ W Q W
applicable laws regulating construction and zoning. W U W W Z�:
CZ W
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY1 w
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDERANAN ATTORNEY BEFORE
RECO I` YOUR NOTICE OF COMMENCEMENT.
L,14/
- -
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to (or affirmed)before me this 12th day of Signed and sworn to (or affirmed)before me this 12th day of
June 2019 by Douq Solomon June 20194:,rian Vick
'-4Q, 1 d
gn,ture f Notary) 4nature o Notary]
[ ]Personally Known OR , Notary [x]Personally Known OR o r^a� Notary Public State of Florida
[Xi Produced Identification O Y PC, igEType
e of Florida .�
lachter [ ]Produced Identification = ^ Jennifer Lynn Schlachter
Type of Identification: Dr r C2G 109844 Type of Identification: My Commission GG 109844
9�FOf,,d 1 of n i
NOTICE OF COMMENCEMENT OFFICE Copy
(PREPARE IN DUPLICATE;
Permit No �aO r-1 -00S 6 177416-0000
Tax Folio No.
State of FLORID-a County of— DUVAL —
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 description of property being improved:
38-2S-29E.918 B DE CASTRO Y FERRER CRANI' PT RECD O/R 16779-1367
Address of property being improved:
1079 Atlantic Blvd Atlantic Beach,FL 32233
General description of improvements: Roof Replacement
Owner Solomon Properties Inc
Address 14255 Beach Blvd Jacksonville,FL 32250
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)------
Name --------------
Address
Contractor Stonebridge Construction Senices L1.0
Address 6956 Phillips Parkway Dr N Jacksonville,FL 32256
Phone No. 904-262-6636 Fax No. 904-262.2247
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 or herself,designated by owner upon whom
notices or other documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself or herself,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 Owner's 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 Q'�•��{o
different date is specified): a
THIS SPACE FOR RECORDER'S USE ONLY NER
�o qc
Signed ___ ___✓ DATE 06-12-19
Before me this 1201 day of June 2019 ------ tt1e m m o
County of Duval,State of Florida,has personally appearedq 02 v
_Uoug Solanon herein by a ° m'Q
himself/herself and affirms that all state me d declarations herein
pro rue and accurate
� n
yr
l o
O�T
Notary ublic at Large.State o1 a County of a
My commission expires:` .o d
Personally KnownProduced Identification Identification oenUxsucE —