2233 SEMINOLE RD #7 - PERMIT ROOF18-0063 CITY OF ATLANTIC BEACH
4",
800 SEMINOLE ROAD
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: ROOF18-0063
Description: Shingle to Shingle &Mod Bit
Estimated Value: 6231
Issue Date: 6/13/2018
Expiration Date: 12/10/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 7
RE Number: 1695190114
PROPERTY OWNER:
Name: SURRATT FAMILY TRUST
Address: C/O ROBERT&JAMIE T SURRATT
JACKSONVILLE, FL 32217
GENERAL CONTRACrOR 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 900F 19
U\0
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building7dept@coab.us IL
_�ate routed:
City web-site: http://Vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
17 -2
Property Address: U103 3CM (nole Department review required Yes No
M_ Lil di n�i
Applicant: -kt r-N Roo �—tn -Manning &Zoning
I Tree Administrator
Project: SKinale, rn o.4 ']�`(/t I! Public Works
Public Utilities
ere-CC (430 Public Safety
Fire Services
Review fee $ D p iqj
LS aty re
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: 2�Approved. DDenied. ONot applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:6—//-,?c)JF
TREE ADMIN. Second Review: FlApproved as revised. OlDenk F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. []Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
u"FICE COPY
Building Permit Application Updated 12/8/17
City of Atlantic Beach r, 2018
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: a003 Semnote I�Dad Ujdt Permit Number:
Legal Description 0? .25-99C&96QW VI/ RE#_IbQ,6
7 Non
Valuation of Work(Replacement Cost)$ Heated/Cooled SP Heated/Cooled/a"� 7
Class of Work(Circle one): New Additio%:A:It:era�ti�o 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 NoQCED
Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
FDescribe in detail the type of work to be performed:Oo Sh- Ld
.\— (I_ t6 le— C)yl 01&ft:sa� N06
PM16-ce Mod.10-f 1k)1JW&J (G04 for& i9JV 5- yGttm
Florida Product Approval#9J193_*& for multiple products uX prodflt approval form
PropertV Owner Information 0 rnaj,1/1114 R()YC� W-61- T41C-
Name:D _f7 VX,Address:::
rer,ri? v;IMM660coho /:r— A Alot-M �3rj' 3 frif G- /-
city 5d:0<s6h 4X07 State PE Zip —Phone 6_q1!5_0
11.A_ 11�
E-Mail z2 0 IV C/27?
Owner or Ag�)t(IiAge6k, Power of Attorney or A�Acy Letter Required)
Contractor Information 0dJnaq1 � -
Name of Compa -- k8tvft64trtr�lIfying Agent: rb Russefl
Mtn F
Address-46b IZ-F-W_�u(4e Im Cftyc�K_rohnS State V-1- Zip-
Office Phone Job SitelContact Number.
Z1
State Certification/Registration#_r-rr .7� E-Mail,DJL,95�(Q 7 t7 Mn W_K600W Fle-Con?
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation rN, VqC, A—
Exempt/Insurer/Lease Employees/Expiration Date
Ap p licatio n is hereby ma d e to o bta 1 n a perm it to d o th e work a n d i nstal I ati ons as in dicated. I certify th at n o wo rk or i nsta I I ation h as
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 OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
A )_�L IL a P V///C-
I �Signature of OwnerT_rAgerlt) +81'gnature OT Contractor)
(including contractor) 441
ffir b fo e me da f orn to(or Aff rm b ore met day of/
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my COMMISSI(A#GG092596
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EXPIRES April 10,2021 . . " My COMMISSION
Produced Identificat o (w1produced Ide . . --,;F.- G092596
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Type of Identification: Type of Identific i n
06d :t ,20181147
13K 1.8307 Page 3 -Pages;
Number
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