2233 SEMINOLE RD #15 - PERMIT ROOF18-0061 CITY OF ATLANTIC BEACH
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: ROOF18-0061
Description: Shingle to Shinige & Mod Bit
Estimated Value: 6090
Issue Date: 6/13/2018
Expiration Date: 12/10/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 15
RE Number: 1695190128
PROPERTY OWNER:
Name: MERRILL CATHERINE J ET AL
Address: C/O CATHERINE MERRILL
LAKE BLUFF, IL 60044-2158
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 INFORMA77ON:
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 Debartment.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Daterouted:._�
City web-site: hftp://www.coab.us J,
APPLICATION REVIEW AND TRACKING FORM
SL &3_Wno le 'r* AaeVarbike
Property Address: 33 _,nt review required Yes ,No
Applicant: Ro n 6`1 Planning &Zoning
J Tree Administrator
_h N % Public Works
Project: Ski a e- M o d �+
Public Utilities
Public Safety
Fire Services
fee $
Der)tSianatur6
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: roved. [:]Denied. FINot applicable
(Circle one.) Comments:
EQ=dI_L_D1jN )=7
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: DAPProved as revised. OlDeVied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
OFFICE COPY
Building Permit Applicatf6h_______ Upd d 113/8/17
'te
City of Atlantic Beach i JUN I
800 Seminole Road,Atlantic Beach,FL 32233
;8 5
z3 Phone:(904)247-5826 Fax:(904)247-5 4 ;�OOF eoo(o
Job Address: aNk Sem)note 1?0�d Ullit Permit, umb4er: 00F 12 t—
RE# — 04-
Legal Descriptionca-.25- rNn_do __�?L
Valuation of Work(Replacement Cost)$ Heated/Cooled SIF Non-Heated/Cooled 1-0-62
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 N ooc�
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:1Ze_1,0oF S14 le- t6 sh i tVL�_- or) (n&A_<_d4zt r06 112.
If YGM.
Florida Product Approval#9J 433-t;5 R4 00'-R 1!7 for multiple products uA prodwct a'pproval form
PropertV Owner Information C/-0 marvin 4 Rkpyc�
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Name:[YeD W flaaW660019("h0P;,0TrX-Address: lvotm 3 3 wif
c 'T q_02 4!1- 3
ity. C 6Cd<Gp-h vi I LV 16e-ach State—V—L_ Zip �57V-ED Phone
E-Mail arla&0612ff n
Owner or Aga-�(if Agen(JPower of Attorney or cy Letter Required)
Contractor Information
Name of CompanN,.—rri ji,Rx+, M4 A !nt:RDber-b RUGSef/
C:
Address 11141--"�N'��s State R_ Zi
le city 'ft(,_Y0hnS p
Office Phone AW.(h A4.k 114 2-- Job Site/Contact Number 5-777(a
A
State Certification/Registration# 13�q E-Mai&6%va V1 t e-Can
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation !-(w kFruw '\, W 20 1,!�OC)Wo A— 011()j IMI(?
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.
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
RECO%ING YOU,,R NOTI 4 CE OF COMMENCEMENT.
J9- e4 k_C�
(Signature of Owne4 o—r AgJnt) _1/ (Signature of Contractor)
(including contractor)
or .r' e e I Qf Si a d sworn to(or ffirme befare me thi Y of
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