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2233 SEMINOLE RD #18 - PERMIT ROOF18-0058 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 -INSPECTION NE LINE 247 5814 ROOF NON SHINGLE - MUST CALL BY 4113M FOR NEXT D"INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROOF18-0058 Description: SHINGLE TO SHINGLE AND MOD. BIT Estimated Value: 6139 Issue Date: 6/13/2018 Expiration Date: 12/10/2018 PROPERTY ADDRESS: Address: 2233 SEMINOLE RD 18 RE Number 1695190134 PROPERTY OWNER: Name: BAILIE LYNN MORTIMER Address: 2233 SEMINOLE RD#18 ATLANTIC BEACH, FL 32233 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 NUMBIER Building Department (TolbeRgned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: G �4 81. City web-site: http://www.coab.us 11 APPLICATION REVIEW AND TRACKING FORM Property AddresS: 2.,7-�SE�N\,IN)D�L—L)� 4� 18 De a. men review required Y -No Applicant: TRkTbP_-) 260DADG Vra—n—ninri, R 7oning Tree Administrator Project: R-�4( Npl�\Lc:'7 J mof-�' Public Works Public Utilities Public Safety 7IN P C�(2_�D So Fire Services Review fee $ Dept Simature 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: E9/Approved. E]Denied. [:]Not applicable (Circle one.) Comments: PLANNING &ZONING Reviewed by: Date: 6—11-dolff- 4 TREE ADMIN. Second Review: [—]Approved as revised. ODenied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. []Denied. F]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 - -- ------- u"'FICE COPY A Building Permit Application JUN YpdRW2/9V 17 �1 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 LJ Job Address: 29-3,3 Seminole Mad UAit -Perrn�] �U D' r: dS_OqQe g - * V Legal Description Lq- )GWI lrlil')A,W V� / RE# Valuation of Work(Replacement Cost)$ Heated/CooIedSF Non-Heated/Cooled 106-7 • 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 Noqc� • 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: triq 16,& 1Ze_v-oqF Sh Ld- i 'v L�o_ on M&#L<_a4rd noo P 4lo-ce 1ptV '5- Y46M Florida Product Approval#FU43355- IN POSEE-3- Rlq for multiple prod ct d(t approval form t I PropertV Owner Informati (;Io Martain� Ployc& T4C_' on 0 , i e:t)CMO aa— M-Addrpq,;: 19;9.5--,A AlOrM 3 Nam L e ei _40) State. PI— Zi Phone E-Mail r 0 Owner or Ag (IfAge Power of Attorney orAg&4 Letter Required) Contractor Information Name of Compag.— M a i t J_yinjAgent:POber bris Address4!;b ., 1ZTWfX.)(;fe_ W& Cjt) — _() State zip Office Phone 601-14 Job Site/Contact Number, State Certification/Registration# CCC_16��q"01 E-MaiI0J(;%Va' IrY taw6on_vt i le-con? Architect Name&Phone# Engineer's Name&Phone# Workers Compensationfl!X�� r\, WC, 9,6 1 6onnnA_ 01/61 ';W19 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 YOUR NOTICE OF COMMENCEMENT. Su A., I P AA0 (Signature-of 0`wn*or Agla�fl (Signature of Contractor) (including contractor) SM and sw 46 zrffi r )before m t day of Sil and swo to affir")b fore me t-'s a f by V V I b U ---ISSY _110 1. 1'.." MYCOdma Mdwk ib'N ES EXPIRES April 10,2021 - %?<ersonally (n' h, /�Qpersonally Kr 6- 'n,,,,, MY COMMISSION#GG092596 I Pro A EXPIRES April 10,2021 duced 11 ]Produced IdE nV,4 Type of Identification: Type of Identific 3tion: U 20181 4,757 OR BK 1.838.6.� Page 2498,t. Nurabor wftgos. scor, R00,19.7 S W d m JL ICLM:0�� 0 . .DIN COUNIT OFFICE Cury pornIaNmeo-00,�_005 legal-dampon X 12 To let Goe aim:!22 q-�,�; AddM=dfpMpcdybq"ft�PM"d ad, Z :3 0 CL <+.Z 0 Lu. a ul A*Rm 10 z C.) cl o AA uj 0 U. cc 0 LL 0 Lij W.cc > C L M W LLJ In LU :3 in 1w uj Lu. Addle= > Fix ub. ui M 4Y#aaan daWis W