2233 Seminole Rd #8 roof permit �� nl 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: ROOF17-0015
Description: SHINGLES, MODIFIED AND INSULATION
Estimated Value: 7000
Issue Date: 7/27/2017
Expiration Date: 1/23/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 8
RE Number: 169519 0101
PROPERTY OWNER:
Name: OCEAN VILLAGE ASSOCIATION INC
Address: C/O SIGNATURE REALTY&MANAGEMENT4003 HARTLEY RD
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name: GEORGE E RIDGE
Address: 140 BAY ST E
JACKSONVILLE, FL32202
Phone: 9043536555
Name: JAMES SHELTON ROOFING
Address: 252 SANTA BARBARA AVE QA JAMES W SHELTON, III
JACKSONVILLE, FL 32254
Phone: 9043536555
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$7,500.
9 ub'I
Building Permit Application OFFICE COPY
City of Atlantic Beach
�,;,I o'• - 800 Seminole Road,Atlantic Beach, FL 32233
G��iJ�y�Jr� Phone:(904 5826 Fax:(904)247--5,,84451
Job Address: '7O J�YNty�DiQ Im (�, q+'a}�O.y{`'f(,Qx�'1 y�,•`�OCJ� RooF i7- OC tS
Legal Descri tido Permlt Number:
P Q01 i3S—'dOl k"nen I V tUBne nnC-P�I'tdr prI*R 0 0k. 4314—
valuation of Work(Replacement Cost)$ RE —_
—�L-B• cLa)_Heated/Cooled SF Non.Heated/Cooled
• Class of Work(Circle one) New Addition Alteration Repair Move Demo Pool Window/Door
• Use ofexisting/proposed structure(s)(Circle one): CommercialResldentla
• If an existing structure,is afire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application If any trees are to be removed or Affidavit of No Tree Removal
D
escribe In detail the type of work t i be performed: zc
10074 - 27 ISoI L- - 7-5a3 - 07 F�r(z
Florida Product Approval# 88 ' 13 1:7,(_-134 .
Prol2ertV Owner Inf2r!natlon for multiple products use product approval form
Name: y� SSS 'T" 2 33 Sem"IVI
City Address:
E-Mall fir„ I� State�_2ip. /Z _Phone S'o
Owner or Agent(if Agent,Power of Attorney or Agency Lette Required)
Contractor Information
Name of Company: "SlLnno9 �Q 1-Inr� ra
Addres ----OG ICA Qualifying Agent
office Phone k{Ics Cltyy�tact Number .l� State -zip
'1D'�Gt�
Z
State Certification/Registration# I Job Site/ConOlB*Z G OW
Architect Name&Phone# rJ R R A L n
Engineer's Name&Phone#
Workers Compensation OQp30 I C-
Exempt/Insurer/Lease Employee /Expiration nate
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 regulation
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 CONDITIONERS,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
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A TTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
r97�anJ�u<-q+E f��
_ {a13•
ISI tureofi m wneror a ti Or Contracpo (Sig u o contract oF) /)�
�i ned nd sworn to or affirn ed efor t �(.,day of SI ned d sworn to(or M )b re this/ y ofp da
u 7j r' by
�-f- by
"uyy i0 NOLE FM1E (Signatureo •,��
EXPIRES
MISSION
ReER
E%PIKES Oc obe 6 2C 5
ae E MNI Ocnb rF92019
A,P"" WnCear6n w.vya i u a
EXPIRES Octobe 6,2019
( 1 Personally Known OR Personally Known OR _,;:• s��cenrn.�w.ryv,az U. wm
I I Produced Identincation l I Produced Identlfl<atlOn
Type of Itlentlticatlon: Type of Identification:
�S Ltl j CITY OF ATLANTIC BEACH
J:S 800 Seminole Road
�.,.. t Atlantic Beach,Florida 32233
OFFICE COPY Telephone(904)247-5800
FAX(904)247-5845
REVISION REQUEST SHEET OR
CO�R[�/ECTIONS TO REVIEW COMMENT
Resubmitted:
Date: ecetyAAAddd b
Permit N ber. !S d6/7ioe/�l p0/�� opZGf Oo2 !
Original Pldns Examiner: Project Name:
Project Address: 6
Contractor: Contact Name:
Contact Phone :q!X/ vrl0 —ZffS J Con e-mail: S
Revision/Plan Check/Permit Fee(s) Due: $ .5'�. 00
Description of Proposed Revision to Existing Permit: n
I
mor= 17 -boL
Additional Increase in Building Value: $ W4 Additional S.F.
Site Plan Revised: /qqqJ Public A W/U Approval:
By signing below. I(Pam name)1 `� A) C all=that the above revision
is inclusive of the proposed changes.
Signature of Contractor/Agent(eon m must sip if increase in valuation) Date
Office IIsi Only
DereApproved: Refected: Nofifiidby:
Plan Review Comments:
De artment review required YesNo m
wilding
Zoning Plans Examiner
Tree Administrator
Public Works 7,27•/ 7
Public Utilities
Public Safety Date a®psa�ans a�..s
Fire Services