239 SEMINOLE RD - ROOF (----
f> J�
' \S) CITY OF ATLANTIC BEACH
:'',. c) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
N-,--.. 0.219,-
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2942
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $5,097.00
Issue Date: 12/28/2015
Expiration Date: 6/25/2016
PROPERTY ADDRESS:
Address: 239 SEMINOLE RD
RE Number: 170525-0000
PROPERTY OWNER:
Name: JEVIC, LEONARD
Address: 239 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
Phone: 904-385-4375
FEES:
BUILDING PERMIT FEE $75.49
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $79.49
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233 p,, Va.
Office(904) 247-5826 Fax(904)247-5845 �5 / Q&d 2 9
Job Address: 239 Seminole Road Permit Number:
Legal Description - - •E S4C7ail Seo / sA t4 VI7 d S arcel#
� Floor Area o f Sq.Ft. Sci.Ft
'
Valuation o ork$ d 9 1 'roposed Work heated/cooled 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 Residential
installed?an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Re-Roof _
Property Owner Information:
Name: Lenny Jevic Address: 23 9 SEMINOLE ROAD
City _Atlantic_Beath_ State FL Zip 32233 Phone 904-662-0062
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: American Roofing of Jacksonville Qualifying Agent: Daniel P. Kinkel
Address: 1015 Atlantic Blvd, Suite 352 City Atlantic Beach State FL Zip 32233
Office Phone Job Site/Contact Number Fax#
State Certification/Registration# RC29027546 -
Architect Name&Phone# NA _
Engineer's Name&Phone# NA
Fee Simple Title Holder Name and Address NA
Bonding Company Name and Address NA
Mortgage Lender Name and Address NA
Application is hereby made to obtain a permit to do the work aid 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(6)months at any time after
work is commenced. 1 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.
/hereby certini that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied 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 ref lating construction or the performance of construction.
Signature of Owner It, ;'/Ar Signature of Contractor/
Print Name Leda o rj 6, 7. Print Name : •NIEL P. KINKEL
Sworn to and subscri d before me Swo o . - I. • bscribed •- , e me
this •2$ Day'of ,20/5' th.: 5%100 1,f r ,20
-- GPI AL RO NYA,4 44`"'s : �1`w�
NO at ry Public , =+. Notary Pub -State of Florida • ',i'
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' •. ! f My Comm.Expires Oct 20.2017 ) �''to,r�.0 Expires /14/2018 oeseQo Revised 01.26.10
;, .��� o: Commission N FF 064624
"''%•° Bonded Though National Notary Assn.
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