1846 SELVA GRANDE DR RERF22-0187 0LANf,,, REROOF SHINGLE PERMIT f
J' PERMIT NUMBER
t 4
CITY OF ATLANTIC BEACH RERF22-0187
u z ISSUED: 8/31/2022
800 SEMINOLE ROAD
'I.on s) ATLANTIC BEACH, FL 32233 EXPIRES: 2/27/2023
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:
1846 SELVA GRANDE DR REROOF SHINGLE SHINGLE ROOF $20679.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169542 5016 SELVA TIERRA
COMPANY: ADDRESS: CITY: STATE: ZIP:
ARMOR ROOFING CO 3885 JULINGTON CREEK RD JACKSONVILLE FL 32223
OWNER: ADDRESS: CITY: STATE: ZIP:
JOHANNSEN ERIK 1846 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
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 $155.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.33
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$159.33
Issued Date:8/31/2022 1 of 1
J- :
- Building Permit Application Updated 10/9/18
,
V- City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
J))' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: ('t;piAQ1>J6‘C.7tiir_, Permit Number: RE RPZ -Z—CD I E2,7
Legal Description 'A-cl% 061.'4S-wti f AI-. p Q i.4 "6 RE# 1691,91051(0
51(0
Valuation of Work(Replacement Cost)$ rn�l (V-A Heated/Cooled SF.3. Non-Heated/Cooledc2?p
• Class of Work: ❑New ❑Addition DAlteration (ARepair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial $&tesidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ANo
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed: ce_COQ. 1 ` (�� NS +S
Florida Product Approval# \ VIN-�1 for multiple products use product approval form
Property Owner Information t
Name ,,Y �3(1 \S n t
Addr-ss b 1 -� \ . t \ ._ 1 '
City . . I't ,;k. State L., Zip .M.* Phone ClaralOVA
E-Mail S\(P.\ty r-7t) f1/4.C .6.611\Owner or Agent (If Agent, Power bney or Agency Letter Required)
Contractor Informati ` /` � `,�`
Name of Company k \\&A ke,, A)�! r�t I Qualifyi : Agent 1� cll.
Address 3z:6:thCly '.� ttav +ea C City 4 State Zip 'WI%
Office Phone �(��"�' Job Site nn cctt1Nuj�ber A - w�_
State Certification/Registration# L.-W.,: w E-Mail le��y�a. �, 10 e., -CM
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation Insurer clkcw,el .• OR Exempt❑ Expiration Date •�1- 1�3
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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
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. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD ► YOU ' NOTICE OF COMMENCEMENT.
..,...m..._,-1-- —
Ab
ignature of Owner or Agent) (Signature of ntractor)
Signed`and sworn t (or affir `i( before me i day of •!ned and sworn to(or affi ,ed before me thi day of
T'���`��'�► ,C , b ' 4I by Allw.- 'L A e - e I
',-,-,e., STEP11 A.KEEN
s `; Notary Public-State of Fiorida 49
moo; Commission#GG 961140
[ ] Personally Known OR .'.*/'`41V' My Comm.Expires May 14.2024 [ ]Personally Known OR Notary Assn :;;.A P TONI GINDLESPERGER
Nin
[) oduced Identifi do Bonded through atoal . [ ] :`::'• :�
Produced Identification �. ,, MY COMMISSION#GG 353178
Type of Identification Type of Identification: -- _. 144..y EXPIRES:October 6,2023
� P, + '•' Bonded ihru Notary FON Underwriters
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