1975 JORDAN ST - PERMIT ROOF18-0049 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
7,
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: ROOF1 8-0049
Description: Replace and Repair Roof Substrate
Estimated Value: 3662.2
Issue Date: 5/9/2018
Expiration Date: 11/5/2018
PROPERTY ADDRESS:
Address: 1975 JORDAN ST
RE Number: 1721060000
PROPERTY OWNER:
Name: JORDANTHEODOREL
Address: 1975 JORDAN ST
ATLANTIC BEACH, FL 32233-4371
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
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 forwork 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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To'be assigned.by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 c6 00
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us L at'��'�oqted:. S/
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Aq-4�-7) PNVr-t91qnt review required Y No
Q_QuiIding_,ZD,
Applicant: Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
eview fee Dept Siq
nature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: MApproved. []Denied. E]Not applicable
(Circle one.) Comments: S" -f P7-Pk" fA Sffr C-4 rd.
C—EU17L D 31 )�
PLANNING &ZONING Reviewed by: rI.- Date:5 '7'2a
4
TREE ADMIN. V
Second Review: F_]Approved as revised. E]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit ApplicationOFFICE Dra'42)(12/13/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: Permit Number: Zoo'r L�S-- C04(,C1
Legal Description RE#
Valuation of Work(Replacement Cost)$ Heated/Cooled'SF Non-Heated/Cooled
4 66) J 0
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Cornmercial CR�e s�i d e nfi a—I
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes (J�DNIA
• 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: t; v-b-C 7L;,,,t-
T, 4 4-C C to. W 0
Florida Product Approval# rL /17/S.-K1:2 F L Q q 7:Z q for multiple products use product approval form
Propertv Owner,linformation
Name: I haa A tv e / , 1tjr1r_,A,, Address:
Cit )_b� R,04& State a zip P�one (Ife
E-Maill
Owner or Agent*Agent, Power-of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Qualifying Agent:
Address City_State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
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,etci!N'@ITII�.C-E.]I-nTa-dj-diliotoat.�eq_,i Ue—m,,eR-,srofJffl,-i.9
Ile I L!h 2 M1,ay Me
e a i i riaI0iEe_sVrii_Cti5nAs!1 ffct 6 i:i RMffisi 1� jo7u7n-dii-nT.FpuOl�i�cor�-srofCt-ii agglan,
a 6
0W
F, T 1 11 1� �E���nL.t.lt S%
__ vii e, Re I O!V Lm e n ta I e n ie a Men,laistriic-fsis telagen,ge q
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 NOTI_ OF COMMENCEMENT.
C1
(SignTture of_0—wRe"r or Agent) (Signature of Contractor)
(incl ud!7gcontractor)
d)befo[e me this 30 day of Signed and sworn to(or affirmed)before me this day of
NIFER J L)dbe(0- 1&7&af� by
Y
MYL;UMMIS-510
EXPIRES:0dober 27,2020
I a t rs
.A,,0:_0. Bonded n"Notari Public U
igNA�jdof Notary) (Signature of Notary)
Personally Known OR Personally Known OR
[V�roclucecl Identification Produced Identification
Type of Identification: FL_ &(�J��s �,L,0,�k- Type of Identification:
UOC ff ;eU1114U4U2, UR BK lUU19 Page 1091, Number Pages: 1, Recorded
06/15/2017 at 08:55 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
Py
NOTICE OF COMMENCEMENT OFFICE L;U
(PREPARE!IN DUPLICATE)
Permit No. A Tax Folio No.
Slate at pkcr�c�c, County of
To whom It may concern.
The undersigned hereby Informs you that Improvements will bo made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following information Is itatod In thlj NOTICI!OF
COMMENCEMENT.
Legal description of property being Improved'.
e)-c-f -61f) fT z
12-SaC) 6/11 A�L. VQIR
Address of property being Improved'
t9`76
General descriptIon of Improvements: 9--r-
Owner 3 Q C-6C:k n -TVCf-IQ&
Address rzo-- eiytC:kC6Q
Ownaes Interest In site of the Improvement OLL...,j3-C C
Fais Simple Titleholder(it other than awrier)
Nume Rogero anrl Williams FILdIding and 0 onfing Conlracials
Address 3415 Karl Read,Jacksonville Florida 32257
Corittactori erem8y S.Rogero
Address 3415 Karl Road Jacksonville Florida 32257
Phone No.004-519-S463 Fox No,004-619-2400
Surely(if any)
Address Amount of bond
Phone No. FaxNo.
Name and address of any person making a loan for the coneStrUction of the Improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon wht]rFk notices or ather
documents may be served'
N.ame I oramey S.Raywo
Address 3415 KoN Road,j acksonville Florida 32257
Phone No.904-S18-5463 Fax No.904-619-2400
In addition to himself.owner designates the following person to receive a copy of the Llenoes Notice as provided In
Section 713.06(2)(b),Florida Statutes.(FIJI In aj Owner's option),
Noma
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date Is one(1)year from the date of recording unles-4 a
different date Is specified): A
Nis SPACE FOR RECORDER'S USE 014LY OW R
G onfid:Y &A
1)4�1,ftth.
wain fly
PAUL ROOERT CASSE"A are true and aCCLItAtO
Commission#FF 39166
My Commission Expires
July 24, 2017
rPubl.1call-drge.-Slat"Ll,kou '*--
It
co
ninlission expires: I.!
arsonaliv 11(nown ........ of
CITY OF ATLANTIC BEACH OFFICE COPY
OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION
CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR
TWO FAMILY RE SIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
I-ERE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
__j
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
ADD�RE S PHONE NUMBER
PRINT NOME
L;
9t(9NATUKE DATE
Before me this day of 201%in the county of
Duval,State of Florida,has personal�y appeared he'rin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of County of
1OHNSTON
42984
1
0
My )N#GG DO
E ,27,2
Pubk UW d
�0 P nally Known JENNIFER JOHNSTON
Zo,ou.ed Identificafion- V uo J,-F My COMMISSION#GG 042984
i EXPIRES:Oct0ber27,2020
B&GInded Thru Notary Pubft Uriderwft.
Notary Signature:
FJBLDG/Omer-Build -tv-SED:4/16/2009
'ATLANTIC BEACH
CITY OF
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION—PHONE LINE-147-59-14
ROOF NON SHINGLE - OFFICE Curt
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFOR14,KTION:
PERMIT NO: ROOF17-0050
Description: SHINGLE AND TOURCH DOWN ROOF
Estimated Value: 5981
Issue Date: 12/21/2017
Expiration Date: 6/19/2018
PROPERTY ADDRESS:
Address: 1975 JORDAN ST
RE Number: 1721060000
PROPERTY OWNER:
Name: JORDANTHEODOREL
Address: 1975 JORDAN ST
ATLANTIC BEACH, FL 32233-4371
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: FLORIDA ROOFING EXPERTS, INC
Address: 4320 DEERWOLF LAKE PKWY SUITE 403
JACKSONVILLE, FIL 32216
Phone:
PERMIT INFORMATION:
Please see aftached 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 NOTICK OF COMMENCEMENT.
* A notice 6f 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.
A OFFICE COPY
Residential Roll Roofing I Techado Residencial de Rollo Residential Roll Roofing Techado Residenclal de Rollo
APPLICATION INSTRUCTIONS FOR MINERAL GUARD'RESIDENTIAL ROLL ROOFING INSTRUCCIONES DE APLICAC16N PARA TECHADO RESIDENCIAL EN ROLLO DE MINERAL GUARD"
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uFFICE COPY
INSPECTIONS REQUIRED FOR PERMITS
To verify compliance with building codes,inspection of the work authorized at various points of the construction are required.The following
inspections are typically for residential projects
Date: Initial: Date: Initial:
Power Poie Swimming Pool steel
Swimming Pool Safety
Piers Electrical Grounding&Bonding
Underground Plumbing U11617 the pool and deck steel is in place but before it Is covered.
Underground Electric swimming Pool Final
Foundation/Footing
Slab Additional Inspections may apply to your project,if your project
Retaining Wal-I Footing contains these elements.
Rough Electric rFormed Columns/Beams
*W17en forms and reinforcing steel, anchor bolts, sleeves, and inserts, and all
Rough Plumbing/Top Out electrical,plumbing,and mechanical work is in place,butbefore concrete is placed
Rough Mechanical
*When a#rough electric,Plumbing,mechanical are complete but before any work is [Structural Steel
covered up. *When all structural steel members are in place and all connections are complete,but
before such work is covered or concealed.
House Wrap V
T-ie-down Framing Connections Swwae %. To-PzH
Wall Sheathing PermitType
Rough Framing
Roof Sheathing
Roofing In Progress
Window Installation-Door
Insulation Ceiling
os 0
Insulation Wall
Permit No.
Exterior Lath 19*75 -S o#t0WWS7r
Scratch Coat Job Address
Drywall/Tile Backer Board rLDRIOA, RooPi0a 6 lop
.Whe�, all wallboard is in place but before joints are taped and finished. Contractor
I
Early',Power
POST THIS CARD WITH PERMITS
Gas Rough IN FRONT OF BUILDING
Gas Final Inspection Line;904-247-5814
*When all gas piping Is complete and wallboard is installed but before gas is attached to Must Gall By 4PM Previous Day
any appliance.All outlets must be capped and pipe pressurized at a minimum of 15 lbs. Building Department Fire Department
Phone:904-247-5826 Phone:904-630-4789
Final Plumbing Fax:904-247-5845 Fax:904-630-4203
Final Electrical Public Works/Public Utilities
Final HVAC Phone:904-247-5834
Final Building Fax:904-247-5843
1 GC Final Construction Hours per City Code
*When all construction work including electrical,plumbing,and mechanical,exterior finish 7 am-7 pm Weekdays
grading,required paving,and landscaping are complete and the building is ready for 9 am-7 pm Weekends
occupancy but before being occupled.