2233 SEMINOLE RD #5 - PERMIT ROOF18-0064 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
I E i fft 10---N-P i 16�N I,L I N E--2 4 7-5 8 14'
NSP
ROOF NON SHINGLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ROOF18-0064
Description: SHINGLE TO SHINGLE & MOD BIT
Estimated Value: 6211
Issue Date: 6/13/2018
Expiration Date: 12/10/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 5
RE Number: 1695190110
PROPERTY OWNER:
Name: FOLEY MARK
Address: 977 SEMINOLE TRL SUITE 187
CHARLOTTESVILLE, VA 22901
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.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 goo
p hone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Dateyouted:
City web-site: http://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3ftin6l'e D!t�ment.review required Yes No
L011 d
Applicant: r) o4� r) Planning &Zoning
Tree Administrator
Public Works
__J
Project: 3VM.nq1C Mp4
Public Utilities
LLT-2 11Sb Public Safety
Fire Services
ReView fee $ De t Signpatture
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 All oholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [�fApproved. ElDenied. ONot applicable
(Circle one.) Comments:
L UiLb-IN-60
-1__
:690-
PLANNING &ZONING Reviewed by: Date: 6-11 -d6�r
TREE ADMIN.
Second Review: [-]Approved as revised. E]Denied. ONot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. [:]Denied. [:]Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
OFFICECOPKilding Permit Application Upd6l ed��2/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: a003 S&mnole i�oad Ujdt PermitNum' ber:
Legal Description 07-as-aq to 6W-1 We Ok
Valuation of Work(Replacement Cost) 7
_q��6 Heated/Cooled SF 100 Non-Heated/Cooled &7
Class of Work(Circle one): New Additio Alteratio Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s) (Circle one): ommerci Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes Noocs:)
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: - v fq
V,emqF Shr I 1,a_ t&- si L,-- on M&&swrd roo P
410-ce wd.19if lut-ox-rM (GO4 ford--1 41V 15YGMM
Florida Product Approval#9J433_t:& eq F"Soa-Rlq for mu tiple products us.Q procipct approval form
PropertV Owner Information C/-O MCLIT-111 9 PbO. W&Ilyi, J�Iqc—
Name: .n W II&O-6600-6100filrM-Ad A I hot-1-h 3T 3trifE/-
City. t Yem 6hVit _e__ State GL_- Zip Phone C?04_e'-
E-Mail 10M
Owner or Aged(If AgenVpower of A orneyorAger(cyVetter Required)
Contractor Information
Name of Co --r-ITv,??a+, na q, Pasibmilteiq tKt _yin 061
mpany v [if &,Agent: I?UG
Address ACJ_ P _N I- t
Afib _!uSt! 1W city-jujohn-I& State 1-1- Zip
Office Phone .1a -Job Site/Contact Number, WA-&5-7776.,
State Certification/Registration# CCC_1;,530b4q E-MaiIft%, V& /t7 =K600(/11 le-com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation fl-tua 000010 /L- 01/614-96o
Exempt/Insurer/Lease Employees/Expiration Date I I
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.
OWNERIS 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
RECORDI G YOUR NOTICE OF COMMENCEMENT.
=9�L' , P
(4Signature of-Owner oVgenA
(including contractor)
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