238 POINSETTIA ST - ROOF \ CITY OF ATLANTIC BEACH
800 SEMINOLE RO AD
J 1 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\Osi19i'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2627
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $8,000.00
Issue Date: 11/4/2015
Expiration Date: 5/2/2016
PROPERTY ADDRESS:
Address: 238 POINSETTIA ST
RE Number: 170571-0000
PROPERTY OWNER:
Name: RIVERA, HECTOR J & CAROLE L, *
Address: 560 LAKEFIELD LN
Contractor TMT ROOFING
Contractor FEES:
BUILDING PERMIT FEE $90.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 238 POINSETTIA ST unit 42 Atlantic Beach FL 32233 Permit Number:
Legal Description /( — /6— 16- e c4 L1'A4(2 Q 1 rcel# 10-16 16-2S-29E
Floor Area of q.Ft. Sq.Ft
Valuation of Work$ d Proposed Work heated/cooled 7-0 t1 U non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial I'esidenti.
installed?an existing structure, is a fire sprinkler system nstalled? (Circle one): • s No N/A
Florida Product Approval# FL#11651.25 R2
For multiple products use product approval form
Describe in detail the type of work to be performed: Shingle tear off installation of ice and water shield and metal over 1x4 purlins
Property Owner Information:
Name: Hector Rivera Address: 238 POINSETTIA ST Unit 42
City Atlantic Beach State Fl-Zip 32233 Phone 6 clot,— 26c— -1 F63
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: TMT Roofing LLC Qualifying Agent: Tyler Turner
Address: 707 SW Butzer DR City Lake City State FL Zip 32024
Office Phone 386-867-3628 Job Site/Contact Number 386-867-3628 Fax#
State Certification/Registration# CCC1330410
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a_period of six j6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that!have read and examined this plication and know the same to he true and correct. All provisions of laws and ordinances governing this
type of work will be compli a ed with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor r[/1/1""li1410
Print Name /c.TO/L 1/47 (Z104,461- Print Name -t 2 ct O R0 ek
Sworn to and subscrl;bed 1iefore me Sworn o and subsc bed before me
this : Day o JJ1/ ,20 (S is 9 Day of low ,20 (6
_ i I. . I. ! -
I �� '�' _ L SHFII ASAMTOS 'LAW; IPAM.�i
Notary Public .a, �� Notary Public,State of Florida • ' - �'ovary Public.State of Florida
Commission#EE 872089 A„ Commission#EE 872089
;;;.,, evised 01.26.10
My comm.expires Feb.10.2017 My Comm.expires Feb.10.201 7