2233 Seminole Rd #20 re-roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 413M FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0082
Description: re-root-FL10674-117&FL15216
Estimated Value: 7000
Issue Date: 8/23/2017
Expiration Date: 2/19/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD 20
RE Number: 169519 0138
PROPERTY OWNER:
Name: SHORSTEIN MICHAEL
Address: 2961 MANDARIN HOLLOW DR
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JAMES SHELTON ROOFING
Address: 252 SANTA BARBARA AVE OA JAMES W SHELTON, III
JACKSONVILLE, FL 32254
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$7,500.
Building Permit Application
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
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Phone:(904)247-5826 Fax:(904)247-5845
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lobAdareas: o1a33 SarYfynok Rd. 60.2-0 /}if4n�wdmrhFvermitNumber:
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Legal Description (/q e.S-,NE 21 9Isl4h0f NFrLb1U0DM situ Dw0tMF1�l #
Valuation of work(Replacement Cost)$Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle oni Addition Alteration Repair Move Demo Pool Wlndow/Door
• Use of existing/proposed structures)(Circle one): Commercialesldent
• 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
Describe In detail the type of work to be performed:
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Florida Product Approval p for multiple products use product approval form
Property Owner InflizMai 2233
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Name:11.CPAt]_L�l. mac -- Address:fig'
City sLLin nL: [ A $tatn, Zip 3A2-33 Phone
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
�ntrector information
N:sme of Company: g)4nte5 She HDn R-00{YYW quell Ing ant: y Stete�_ZIP��-25
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Address,_
Office PhO.^.e�Q^� � ^4 ZO lab$Ire/Contact Number
State Certification/Registr #t one l gt pna l� �(�•Mall
Architect Name&Phone# _
Engineer's Name&Phone# _
Workers Compensation Eypp,pt/Inwrer/tease Employwa/Expintbn pets
Application is hereby made to obtain a permit to do the work and installations as Indicated.I certify that no work or Installation has
ng
consitrruction inenced ith s jurisdiction..Iunderstand that ahseparate permit must Oe secured for tELECTRICAL FWORK,IPLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANK$,end AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information Is accurate and that all work will be done incompliance 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 ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT,
cAo ` Imature of coni
nota of owner or Aean indudl Cuntrecrorl
Signed and sworn to(or affirmed)before met'his d_adby of SI ed an worn y((or affirm/e�d),be�f�or�e�m�e meth day of
for by o VuS�' a1A0a' by
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f I Produced Idetli PC Of Identification: 4
Type of identification: