1570 PARK TERR W - ROOF CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
REROOF SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RERF17-0145
Description: re-roof FL10674-R10 & FL15216
Estimated Value: 46088
Issue Date: 10/17/2017
Expiration Date: 4/15/2018
PROPERTY ADDRESS:
Address: 1570 W PARK TER
RE Number: 171942 0000
PROPERTY OWNER:
Name: ALLOWAY ROSS G
Address: 13979 N SPOONBILL ST
JACKSONVILLE, FL 32224
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Maxxim Construction
Address: 3269 Doctors Lake Drive
Orange Park, FL 32073
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$7,500.
DocuSiggn Envelope ID:896D0075-4BEC-4714-AB1A-92B303350002
uocu~aign envelope IL):309000/34)101-486E-AA15-91706411-CM4
Building Permit Application
N :r. City of Atlantic Beach
V.-,,,,,•.:,-,:4P:7 • 800 Seminole Road,Atlantic Beach, FL 32233
����"`'' Phone: (904)247-5826 Fax:(904)247-5845
y �ry
Job Address: i 51 0 Y t,r t—r vt-rr&ce. Li Q..a-'( Permit Number: l (C-{s
Legal Description 2,1 to i to -Ls -24 C. SE LVA ANA'si \NA V -)1TZLON REE#a I 122 I -oc 36
Valuation of Work(Replacement Cost)$ 1(O 1O`6%'O° Heated/Cooled SF jaLi,I Non-Heated/Cooled f" 4 rt y
• Class of Work(Circle one):opAddition Alteration ath Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residentia
• If an existing structure,is a fire sprinkler system installed?(Circle one : Yes No N/
• 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 performe :
Florida Product Approval# GL,, i 04,1&f -F,US c. is-t t`„ for multiple products use product approval form
Property Owner Information
Name:_j,4iZnS� Address: l$70 Pp„-K. Tv.rfiwry 'M!a,S#
City State_Pl,.. Zip 31,1,41 _Phone 41,39 -I,t2o- `1.401
E-Mail r'tis.S c;,,11.w a �n}+t etitA •r.,*"
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) i?..,x•,,n Mej errs rt
Contractor Information
Name of Company: eqa.4...1e1 c't..struvi-,o,. L.Nr... Qualifying Agent: ?, ya('N MG n, rE.
;Z.
Address L°L.4)/14-04.6r3 lak,p Or _,City_ 0,-A,,,,, Pdv-e_ State FL Zip 12 "S
0t(
Office Phone 06;173--6L Job Site/Contact Nunber 11O'1— -177-SiS`0
State Certification/Registration#CCC, 111_11 yr- E-Mail , :r,+yrr rya... (c? 1.-,e*r..1..4.h c w.+et
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation ex,e rn.pw -].J-{p /j l
r Exempt/insurer/Lease Employees/Expiration Date
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 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 AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
e oxuSigned by. —DocuS fined by:
rbSs Qib1,vai7 _ lkulAblifr..J rifklit
(Signature of&wnceatanevenirHtitiuding Contractor) (SIignetfaMe tatftftor)
Signed and sworn to(or affirmed)before me this 4lr day of Signed and sworn to(or affirmed)before me this J day of
Q/f bee , 20V7 ,by 1ro s. A till. A W_ C?c tike__- , to ri ,by. p.ei r] _
4..,_ l __?
(Signature of Notaty) (Si t ; gf trti wn C. L1ves
`���.'fi Shawn C. Livesey �•.ti- fl� gY
`'�• Commission i GUAM()
Q,. di. Commission 0 0605T); _ �•,
ice_ i a tuber 22,2020
res:t)8CA
-r�" %�� :"= Fxiaire: L:amber 22,I(i ,;40r411::41 Bonded thru Aaron Notary
[ }Pe sonaily Known OR pie_ � `a��` • i )Personally Known OR .,,,a s
(' duced Identification ',, ,e BOflded thru Aaron Not ,roduced Identification ,!,
Type of Identification: S.4-0., 1 Type of Identification:_ S.H 4 _. t b ,