2233 SEMINOLE RD #17 - PERMIT ROOF18-0059 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: ROOF18-0059
Description: Shingle to Shingle & Mod Bit
Estimated Value: 6209
Issue Date: 6/13/2018
Expiration Date: 12/10/2018
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 17
RE Number: 1695190132
PROPERTY OWNER:
Name: GAYE S SAGER REVOCABLE TRUST
Address: 7670 SMULLIAN TRL W
JACKSONVILLE, FL 32217-3502
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 Department.)
eminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us te routed.
City web-site: http://vmw.coab.us Da
APPLICATION REVIEW AND TRACKING FORM
I
16-
Property Address: 2-Z-3 Sewwle_ /7 a4ment review required Yes
��LW=�Qind_ 7'�No
Applicant: M671bm RoA ii a '15t�nnflrl R Zoning
;t:—1 Tree Administrator
Project: 41C Md -81- Public Works
J- Public Utilities
Public Safety
Fire Services
Review fee $ D�Ti§lglnature
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: [EApproved. OlDenied. ONot applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:.6_//]��
TREE ADMIN. V
Second Review: DApproved as revised. E]Denied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. F]Denied. F]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
Building Permit Applicat� Updated 12� 1/17
�8
N
City of Atlantic Beach JUN
H 1 2018
800 Seminole Road,Atlantic Beach,FL 32233 1
(V51 Phone:(904)247-5826 Fax:(904)247-5845
___J
JobAddress: 2,q33 semnote Poad uAit PermitfX er:
Legal Description 07--as- i0own Vil , 1' 60&1) RE# ��-MY
Valuation of Work(Replacement Cost)$ !ated/Cooled SF_&6 Non-Heated/Cooled
�7_ 1/0&
Class of Work(Circle one): New Additio Alteratio Repair Move Demo Pool Window/Door
Use of exist!ng/prop osed structure(s) (Circle one): � ommerci Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes Nooc�
Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
rDescribe in detail the type of workto be performed:V'e-I-oor Sill rtq to- 1-6-Gil I 10o' on (r[&&so.Pd_ rco
141aa MoCt.bif'hj1-bg-red (Go4 -t�r& J;pJV tr"\
Florida Product Approval# 1:�Lr for multiple products u prod Vctapproval form
JI
0 rrC
Property Owner Information c L1,
.fl) " ]vm
Nam w ilaa f7, -Address: sas--'A Alorm 3r-O 3trea
City 0hV1 a State. LL__ z I 32)E�Q _Phone %Q4� le�_95V
E-Mail ri 4/1776&2/7 V
Owner or Agint(If Ag t, wer of Attorney or Ad&)ty Letter Required)
Contractor Information 0
Name of Compan ]if in�
j_y Agent:ppberb PuGse-f/
C.t Z,p
Address4th U-13N 'u )MO I y LIL,)OhYiS State
Office Phone Job Site Contact Number
State Certification/Registration# CCC 13�q�l E-Mail Q th Abn wLKf2QoVd'1e-Can?
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensationf�-Omklylr_Wn rN, WC, 9,6M60tMA- 4161 /mlq
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=E OF COMMENCEMENT.
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