1868 Sea Oats Dr re-roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
y ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-3262
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $10,000.00
Issue Date: 2/15/2017
Expiration Date: 8/14/2017
PROPERTY ADDRESS:
Address: 1868 SEA OATS DR
RE Number: 172020-0576
PROPERTY OWNER:
Name: BARROW, CLAUDE H
Address: 1868 SEA OATS DR
GENERAL CONTRACTOR INFORMATION:
Name: SCHULTZ ROOFING COMPANY INC
Douglas Arthur Schultz,CCC036989
Address: 216 N 20TH ST QA DOUGLAS ARTHUR SCHULTZ
Phone: -
FEES:
BUILDING PERMIT FEE $100.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
E&DING PERMIT APPLICATIO
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
,,rr�� Office(9y0�4)247-5826 Fax(904)247-5845 17 RooF - 3 Z (oZ
Job Address:18(p -. ,SF4 [Jd�S Vf.. Permtitl�mber
n• 4Lo / /�9�/�K
Legal Description 3[0 -aZ0 q -a ;S _a 4 C Se/Ita nna Parcel#
Valuation ofWorkS lO," � P•O
Floor Am o q.N. 'q.Ft
SClawProposedWork heated/cooled 125 non-heatedlicooied 15 q5-
Class
of Work(circle one): New Addition Alteration Repan Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial R qa
If an eaisling structure,is a f re s rinkler s Stem installed?(Circle one): Yes No N/A
Florida Product Approval# rvl of 1, nt' S-).,i,n 1eS 4ZL14- 1O1 4 • I f
For multiple products use pro act approve oroa F�-1 k- u - note/� titan
�I-Ae c U
Describe in detail the type of work to be performed:
Property Owner Information: m ,�
Name: ,h errI C L �Q/r0 uJ Address: / 0 �0 8 Sea (SYS Or .
City c- A State Zm 2 ?3 Phone RD V '
E-Mail or Fax#(Optional)
Contractor Information: (' n - /�
Company Name:_ C�'1 1tz_LS.Q01,11q CO. TnC .Quaking Agent: r'U"I a 5 A . SGr�u-�
Address: llp N 30'w_• "S� ' City, t1clSSa(lU�lI _ We Ft Zip ZS22 .si
(Xtlw Phone glJ4 Job Site/Concoct Number —I S 9 -ODto
Stam Certification/Registration# GCC. fJ (o Q A r1
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Leader Name and Address
Application is hereby made to obtain a permil to do the work and installations as indicated I ceriify that no work a installation has commenced prior to the
issuance o apermit and thin d/work will be p¢rfarmed to meet the standards ofall laws regulating construction m thisjurisdiction. Thispermit becomes mall
and void t work is not comm medwhhin s&(6J months.ar if ewhoo,tion or work is e7eriled or abandoxdfor a period ofina 6)months at any time after
work is commenced. I understand that separate permiU must be secured for EledNeN Wark Pb1mWgg,S10M, Wdk Pam"/s, urnoev,Boilers,Aeolers,
TamksaMAlr Comalsho ers,Ha
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 I haw recd and examined this application coil Mow the same to be true aruf correct. All provviom oflawr arM ordinances governing this
type g waR will be complied with whether specified hereim or mat The granting of a permit dace mol presume la gyve aulhoriry to violate a carrc¢(the
promstons ofamy otherfederol,state.or local taw regu(adng consuuegan or the performance oJcombuclian.
kignature of Owner �//// --- Signatureof Contractor
Pri�tName _L u E/7`— otl _ Print Name ��, Y4
SworntoandsubscAbod before me Swo to and su 'bed before me //
this/7_Day of (?I.u._ .20 �� rsripL,/�l Day o
Y1N r R0Mi a M tH .
otary Public .1 r wr OOMa:ssa�nt��Rissr'?y: Notary Pu c o :•, lir 00MMIa910M/5111
EXPIRES Jura 3n.N19 ` : I XPAN a 11.' I
bi swarm.. rem.ewrs..�..a. ey
IW II w••OrN
NO1%E OF COMMENCEANT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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: 3(0 a0 q ' oZ S — aq (r
-- Seluo, Marrr'na U-),-f 9
Lot r < Z
Address of property being improved: ��o WSf Q an--fS Dr.
.
General description of improvements: n
Owner Ci\2,Y��I eLe-, I�Yt C f O U-) C _ _
Address l g (O9 SE, (_.a. S \ v , l
Owner's interest in site of the improvement t2 e
Fee Simple Titleholder(if other than owner)
Name
p� Address
Contractor CO ` c `- n c. 0 "G' (2S
Address
Phone No. U-i �"A6- 0) ll Fax No. f✓�I r� y. �7.,y 3i2���
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.