1057 Beach Ave re-roof permit 0'tLrr.,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF17-0028
Description: GACO SILICONE COATING
Estimated Value: 940
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 1057 BEACH AVE
RE Number: 170266 0000
PROPERTY OW NER:
Name: LOFF HOWARD J
Address: 1057 BEACH AVE
ATLANTIC BEACH, FL 32233-5753
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: RELIANT ROOFING INC RYAN SHOUPPE
Address: 528 Millhouse Lane Orange PARK
ORANGE PARK, FL 32065
Phone:
PERMIT INFORMATION:
Please see attached 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 (To be assigned by the Building Department.)
800 Seminole Road g
Atlantic Beach,Flodda 32233-5445 oor
Phone(904)247-5826- Fax(904)247-5845 t `
E-mail: building-dept(Mcoab.us Date routed:
Cityweb-site: hap:11www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I d57 [?-.-,C—NQ_6( kVA D ent review re aired Ye No
((�� Building
Applicant: � 6LIP,oJ-C I�.2OFrtJ(: -Plartrnng&Zoning
l^16
Z— Tree Administrator
Project: QAeo �Ilrtt_0NpC. WflT,A-)C Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns 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: ❑Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDIN 1
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. []Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2019
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLAN'I IC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
YY11,,,, Office(904)247-5826 Fax(904)247-5845 �7
Job Address: d57 CJrQCh AV2• Permit Number:��F / — OOZE.
C-1 16-25-a9f R+IarrliC e;each "".S' -7 /
Legal Description S. L AIle 41 Parcel# � I �Zto fa— 0200
r�I1 Floor Area of STFt. Sq.Ft
Valuation of Work S -Il�.00 Proposed Work heated/cooled j28Z non-heated/coaled 4345
Clanof Wark(drde one): New Addition Altera. n Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential yy
If an existing structure,is afire sprinkler system installed?(Circle one): Yes No N/AZ
Florida Product Approval# I n9} IY%QGACOGdifone (A0.i1nQOVef V10. 00all"on of new l-louse,
For multiple products use product approval form (New ( V Al on) rf g- Ir31'7;?q f
Describe in detail the type of work to be perfamrwdJln( nII q faACO S)Ilcanr Coop{YnQ ave—
(-flat aCU1+10nof house(NewC1Jns+rU0hbrt)
Prifts"Owner Inforruatiam
Name: VI LCt Lo FF Address: 1057 13e,&[h AVC.
city A+Inn+tegeacH SteteELZipA771-A Phone Let 041 - RCI 1-9188
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Remm awnau,ne Qualifying Agent can onshwwa
Address:e2x Auatmmssw.alo City osaws saaawe We n Zip >s�
Office Phase srnsso J.b Site/Conron Number ca.mm.ano,mw-wsmrmeo Fax# wen-ter:
State Certfficetion/Registmtim#ocel2smis
Architect Nsme&Phone#
Engineer's Name&Phone#
Fee Simple Title Halder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
sh,plassio,is he,abyawd,i—brainas do b rt aMm,lallaaoes as indicated. / M1 wi tall M1 emedgnwm We
ll d wwsoo,rcawa,,m000dlhnaJlwokMfiFbpee/6sdmFwet awslandards ciallhaivs' replad17' Fi,l dl Thi,pebmn Emame,
m —c—soj mM d e ( p of. (6)mmatamdme
rnhe MA Cnd�rno qWork
cof Moonshine,Shan,. Wath.Prep Fonrcn,Bwff ;
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO ORDRATEBEFRETREINRNTEOFR
URL LENDER ATTORNEY BEFORE Y611OIC
COMMENCEMENT.
Iherehi m#b hm)haoe readandes—i—lohispli atiw ndiso—oremme m lee lrwandrnrrecl. Anprori,ln,a/mwanewdinnce,go,erniM1¢Ni,
W of wank will M mmplia with whether n rr red Aemn or now. the nnag?/a Notart doer no,prewme to erne awhoon,to vwmre ur muel We
pro .nn,o/anyarM1er lr✓erol.amrr.or l«m( reguladogroor riepef--avidnnnxron.
Signature of Owneratu
Signreof Con.actor
Print Name Print Name -.- Cameron Shouppe
Swam to and subscribed before me Swam to and subscribed before rile
this I Ibv of &USi$� _20/7 this a, Dayof AU ill&-r .20 /7
No*NOTARY
N t Publc
nnifer Klaut Je miler iyad Revised 01.26.10
PUBLIC NOTARYPUBLIC
ATE OF FLORIDA STATE OF FLORIDA
mm#FF951584 CcmffW FF951554
xpires 1/19/2020 t Expires 1/19/2020
Doc N 2017187351, OR EK 18084 Page 1517, Number Pages: 1, Recorded
08/10/2017 at 11:16 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
OFFICE COPY
NOTICE OF COMMENCEMENT
/� mneFaAe lry puFuuTkT
Foment No. ROOT l 063k Tax Folb No.
Stele at Cmntyor rSrry __
To wham It may coram:
The teadersigned hereby brforme you that kmrovemants will be made to cerlaln real Property,and In
eccordanev with Section 713 of the Fbdda Smhrtes,the following tnfom r-H-1,Is ended In In&NOTICE OF
COMMENCEMENT.
Legal*-4P'-of property being Improved:(n'9 9 G-7 S-9 9 F A4I OYIii, RPD Y'P
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Address of lnabarty being imprd. .^n, C17 peachA
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Owns/e IMemsl h sit.of the inymaement
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Surety(very)
Address_ tofbaMS
Phone No. Fax No.
Name and addran of any Person making a Man torthe am6tlKYNn Nf the inprovaranb
Nees
Md..
Phone No Fax No.
Name aperson wdtNn the State of FlorMa othertren hlmeet,eesignafed by at upon whom notices or other
doermrems may be served:
Name
Add.
Plane No. Fax No.
In eddbbn In himaeK,owner dealgnates Me RNOabrp Ireton,ed receive a apy of to Lienees None,as Pro rUfad In
Section 713.06(2)(b),Ronda Stahmms.(FM M el carnal option).
Name
Andrade
Phone No. Fax No.
Baden dee 0 NNIIS M Comma,Nemere(pa ex irabon date Is one(1)year Rom the deb of reardng uNaesa
Merant data hr spetlfhed):
THIS SPACE FOR RECORDER'S USE ONLY /I/ -ER
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NOTARY PUBLIC
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