159 11th St roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NE]Cr DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF17-0011
Description: ENTEGRA CONCRETE BARREL TILE
Estimated Value: 328DO
Issue Date: 7/13/2017
Expiration Date: 1/9/2018
PROPERTY ADDRESS:
Address: 159 1 ITH ST
RE Number: 1702740000
PROPERTYOWNER:
Name: HENDERSON ROBERT W
Address: 159 1 1TH ST
ATLANTIC BEACH, FIL 32233-5751
GENERAL CONTRACrOR INFORMATION:
Name:
Address;
Phone:
Name: STONEBRIDGE CONSTRUCTION
Address: 12550 AGATITE RD 6956 PHILLIPS PARKWAY DR N
JACKSONVILLE
JACKSONVILLE, FL 32258
Phone:
PERMIT INFORMATION:
Please see aftached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department Cro be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-W5 R00F 1-7 -
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Date routed: & z�>
Cityweb-site: http://�.mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: kei 00!�ynt review required Yes No
u long
Applicant: ftrmIP4&Zoning
i ree A13mmisiraror
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review fee Qept Signature
Other Agency Review or Permit Required Review o ceipt
of Pe—it Ver! led By Date
Florida Dept.of Environmental Protection
Florida Dept.of Tmnsportafion
StJohns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 54Approved. DDemed. E]Not applicable
(Circle one.) Comments: IN-V-T-C'A 4�
BUILDING -C>0__ O'k � I-r-e_
PLANNING &ZONING Reviewed by: Date: 45
TREEADMIN. Second Review: [:]Approved as revised. -]Not applicable
]Denied. F
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: OApproved as revised. ODenied. E]Not applicable
Comments:
Reviewed by: Date:—
Revised 0511912017
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:1904)247-5926 Fax:(904)247-5945
Job Address: C� PA�CLO hC� ()eaP_h 'P L SWI�) Permit Number: Roc)F-7 1'7- Q 0 f
Valuation of Work(Replacement Cost)$M Ml),Oo Heated/Cooled SF LQ`5D Non-Heated/Coolexl_�Pt-q
• Class of Work(Circle one): New Addition Q�i�p Repair Mchie Demo Pool Window/Door
• Use of existimiliffirmosed structure(s)iarde me): Commercial Cesl�deotlai)
• IT an existing structure,is a fire smolder system Installed?(Circle me): Yes No C/A)
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidsw[t of No Tree Removal
Describe In detall the type of work to be performed:
�Li �toactm"-Enten���bncyoe_ 50t�
FloriclaProductApprovall! 'FL ML)L+-V) A —for multiple products use product approval form
Pinciperty censer lnfwnugon
Name: Addre!ISA�111 �OAI("_+
city a —State V1 zlpx,2k� Phone
E-Mail
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Informado
Name of Company:lbub�lklf 60�)WV iMS Quanping Agent: 9�'QTI V�C'y
Adifiress)OC120 Vnillip2KNdi� city �Wylwyillr .state zip "A3NO
Office Phone IJ1JQ-,QUA-Qla'50j —Job Site/Contact Number Z*An "M'i�_'104-()I a iz�
State Certiflantion/Registration E-Mail. Cum —
Architect Name&Phone#
Engineer's Name&Phone
Workers Compensation
E.0/Ini xwse E.P"./Exz1rxfie,,Di,b,
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 regulationg
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 CONDITION ERS,etc.
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
co
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEI D
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
YOU ICE F COMMENCEMENT. P z"
Is
RE
m of OnmerepAgentincludingCon r (111gradlFe of�e,Aniex"
is d
and we=to(or affirmed)before me this ay of Igned and on to(or affirrned)!!'fre me
fioan� 1 -7 by AOtk
9 CL
E
(Staraturn,0 Notani) (54 turecififietary)
onally Known OR Personally Knowi OR
uced Identificition I Produced Identificnion
pe identification: JCA'� Type of Identification:
Doe # 2017140266, OR BE 18019 Page 405, Number Pages: 1, Recorded 06/14/2017
at 04:17 PM, Ronnie Fussell CLERK CIRCUIT COURT Di COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
IPal al D.I.Ts
P.mi No _ Tort Fogo No, 170274-0000
SIM.of �111 Coall nw-
To iiihihin it my condthri:
Th.lathdrilighil broadly I.I.M.I.the all to handa ad Farrill"I-M pol add I-
tiodlinded..111I Sondlihn 713 of in.Florida whomal th.famming litiondiall.1.ritatild In tha NOTICE OF
COMMENCEMENT.
,ago,oinalplion I wohany wing wriproinew 6-1 16-2S-29E ATLANTIC BEACH
E 25FT LOTS 1.2&W 53FT LOTS 8.7 BLK 43
AddmddfP`*P�"baMgIdQ . 159 11 th Street Athnift aC 32223-5751
thinaral derabablitift of linlandandandW Roof Replacement
.Robert&Lyran Henderson
Add. 159 1 Th Streel AtIal Beach.FL 32223,5751
Nam
AM.
Prothe No.st"Fe"S" Fad No 90,14552-2247
"Mountdiiands
Ph..Md Pa.No
N&M.al MMM.0 My paragin.01,a 1.W IM PinddAr a tra mairvaram.
lihom
Add.
phom Mo. File No
Nam of Ferri Minh the Stare 0 Florida.door than hinal ft,l,n.Wd by..no,apon"om noticed or other
May ba$.,W:
No.
Adderal
Fand.No. Far W
In adear,W Mmaj .,".0al ra Widi iiana.W.....,P,0 To-Il Nood.e provided In
SM.,713.015(2)to).A.M.Slintitild,(Fill in at�id. Wkn).
Nam
Md..
PW.W-Fair No
E,Pirii ion data expirationalaft obtaill),aiiirlonam
I
deal data-1-Pardiffilad):
THISOPACEFORRECCHIR'll 11 1
DATE
:Z
Iry
a
Ny
Forivirazi
14