2233 Seminole Rd #37 roof permit ?S' J
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)IT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF17-0020
Description: SHINGLE, MODIFIED AND INSULATION
Estimated Value: 7000
Issue Date: 7/27/2017
Expiration Date: 1/23/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 37
RE Number: 169519 0158
PROPERTY OWNER:
Name: KENNY PETER
Address: 2233 SEMINOLE RD UNIT#30
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name: GEORGE RIDGE
Address: 140 E BAY ST
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$7,500.
Building Permit Application
m City of Atlantic Beach OFFICE COPY
unl�r V 800 Seminole Road,Atlantic Beach, FL 32233
Phone:(904) 247-5826 Fax: (904)247-5845
lob Address:aU S tjf101 Pd. AO-}87 A,yla_ FL32"33 I5�� T
" ' ^*"�fU R/i4Jti Permit Number: ' `03P- 1-7 —0O2V
Legal Description D ,TQC per+ Njt�y OA/E-LnuMN ul� Dili f ORE#37 R BK 3 - /O
Valuation of Work(Replacement Cost)$ 2 0Q
Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): (9)Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): commercial• eside
If an existing structure,is a fire sprinkler system Installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application rIf any trees are to be removed or Affidavit of No Tree Removal escrihe In tletail the type of work to be performed:
LRe-Roof
Florida Product Approval# for multiple products use product a
Pro E Ow er rfor on P pProval form
Name: Address: ,37
City state�zlp 3223
E-Mail t0 — _Phone -
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: , Zooh;K4 qualifying Agent:
Address 5 CltyJAC.�SdYL✓1 E e. State L zip 32?5'
Job Si
Vince Phone�- - Site/Contact Number
State Certification/Registration# ob Site/Contact
Architect Name&Phone#
Engineer's Name&Phone#_ f-N f
Workers Compensation k
Exempt/Insurer/Lease Employees/Explratlon Dace
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 ORA ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
_
IP-/
IS of Owner or Agent including contractor ( gnature f ontractor) AL
��//ss��
Sig d an sworn (or a 'rmed) fore fi a of Signed and sworn to or affirm d) efor e t is& of
O
by by
gnature of Notary) (Sig t eofN tary)
TONI GINDIESPERGER
MYCOWISSIONYFF924951 'I t �i TINIER ESPERGER
o- EXPIRES October 6,2]19 4-i MV GCM14k1551641FF 924951
IjPersonally Kn rF sem' SoWd Th.W:ar PUYc U,pen;,an ( I Personally Known OR - EXPIRES'.October 6.M19
i IProduced Iden *'t,p.4y^." 6snCcj iCm tbay Puere UMxwdt^rs
Type of Identil cation: I I Produced Identification
an /Z `
Type of Identification: U Cl