2233 SEMINOLE RD #25 - PERMIT RERF18-0103 ",1j--
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: RERF18-0103
Description: SHINGLE ROOF
Estimated Value: 4403
Issue Date: 5/4/2018
Expiration Date: 10/31/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 25
RE Number: 1695190148
PROPERTY OWNER:
Name: COOPER WILLIAM G & MALLORY D ET AL
Address: 13860 LONGS LANDING RD E
JACKSONVILLE, FL 32225-5422
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Triton Roofing & Restoration LLC
Address: 480 State Rd 13 Ste 106-348
St Johns, FL 32259
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.
NOTICE: In addition to the requirements of this permit, there may be.additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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$7,500.
Building Permit Application Upclate�12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
JobAddress: 40r*v% 13 jzld&��6 ko-a- A/i Permit Number: R
Legal Description M, //7/I12/9/yA r- -RE#
/ &?Zdo 412'S. 16 0/IT
Valuation of Work(Replacement Cost)$ 1-144;) SWHe'ated/Cooled SF qOO Non-Heated/Cooled 900
Class of Work(Circle one): New Addition teration epair Move Demo Pool Window/Door
Use of existing/proposed structure(s) (Circle one): '4�Zom�me J Residential
a
a 11111
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If an existing structure,is a fire sprinkler system inst irc 0 ne): Yes No 429:)
Submit a Tree Removal Permit'Application if any trees are to be removed or Afficlaviito-T No Tree Removal
Describe in detail the type of work to be performed-
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Florida Product Approval 0 S;) fo Iti 12 P9 ucts use p uct prova.Lfqrm
Property Owner Information 0
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Name-. 6)Q04LY1RfJ& 6k, &O_Address: tnS-A
city [ III
WW &L-CA Stat�V--L- Zip
E-Mail QV104 LQ) =Y-tacvt6LX.r6�__ ' - L—Phone 9Z9 (a
Owner or Agent(h4Agent, Power of AttornC%yfor Agency Letter Required)
Contractor Information
Name of Company. �Qua i in Ag�mt:
Ad d ress -5 72-
AIM-> 1��Iv JS
Stat Zip
Officephone Job Site/Contact Numbe
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State Certification/Re-gistration# E-Mail- 6V -0--=0 6? .(ICM
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation 0-y-rink("ru-M
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. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
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 ORAN ATTORNEY BEFORE
RECORDIN Y OUR NOTICE OF COMMENCEMENT.
/Z
_X (Sign e of Contractor)
gignature4ownero Agent)'
(including contractor)
i n d and sw ffirmW fore me thil s-k of S' d and swor t )o affi r 4efore me thi d f
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fta. State of Flo6da Y CM7S-00olt
Personally X
Personally Known'DR !,V; :nown V, EXPIRES April 10,2021
b?roduced Identification%.",y My Commission apires 01110/2021 1 Produced Identific tion...
Type of Identification: Commission No.GG 61272 Type of Identification:
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