510 Aquatic Dr RERF19-0050 Shingle Roof REROOF SHINGLE PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH RERF29-0050
l f4 800 ROAD
ISSUED:4/2/2019
' y ATLANTIC BEACH.
FL 32233 EXPIRES:9/29/2013
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTI4
• • • • • • • • r • • • • • R
CODE, AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF r
NOT—E; In addition to the requirements of this permit,there maybe additional restrictions applicable to this property
that iay 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE CIE
510 AQUATIC DR REROOF SHINGLE SHINGLE ROOF $7998.0
TYPE OF • BIJILrING USE B
4 • GROUP:
171818 5170 AQUATIC GAF
COMPANY: rs •
MACK BROTHERS GENERAL 1546 GIRVIN RD UNIT 1 JACKSONVILLE FL 3222',
CONTRACTORS
• ADDRESSi' CITY: STATE- I
MCWAYNE DUFFY P 510 AQUATIC DR ATLANTIC BEACH FL 3223
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RE
IN YOUR 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.
LIST OF • r
7R.11.ffffntainer company must be on City approved list. Container cannot be placed on City right-of-way.
Sal
DESCRIPTION ACC UNT QUANTITY -Waa DAM0 NT{
8UIIDINGPERMIT45500M322-1000 0
STATE DBPR SURCHARGE 4550000808-0700 0
STATE DCA SURCHARGE 455-0000-208-0600 0
TO-
Issurd Data 4/2/2019
of t
Building Permit Application Updwed)019,)8
City of Atlantic Beach Building Department "ALL INFORMATION
V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept(cicoab.us IS REQUIRED.
Job Address: 510 Aquatic Dr. Permit Number. U\ RF ( C) ' y cSc)
Legal Description 38-71 17-2S-29E Aquatic Gardens Lot 9 - C RE# 171818-5170
Valuation of Work(Replacement Cost)$7998-00 Heated/Cooled SF Now Heated/Cooled
• Oassof Work: ONew OAdiition DAheration Repair OMove GDemo OPool OWindow/Door
• Useofecirting/proposedstructure(s): OCommercial Xesidential
• If an existing structure,is a fire sprinkler system installed?: OYes ONo
• Will removed ociation with r ro'ect?OYes(must submit simarateTr Removal Pr,m,tl YN.
Describe in detail the type of work to be performed: Total Rerooftounit. FL#1 0124.1 sh I ng les, FL#16160.1Off-
ridge vents, FL# 17401.1 Underlayment
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Duffy & Linda McWayne Address 510 Aquatic Dr.
City Atlantic Reach State FL—zip 32233 Phone 241-0921
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Mack Brothers Building Contractors. Inc. Qualifying Agent Frederick W. Mack
Address 1646 Girvin Rd Unit i City Jacksonville State FL—Zip 32225
Office Phone (9041220-2500 Job 5ite Contact Number (904)237-0868
State Certification/Registration#CCC1329497 E-Mall mackbbcl@gmail.com
Architect Name&Phone#
Engineers Name&Phone#
Workers Compensation Insurer Southern Owners Ins OR Exempt O Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.)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 regulating
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,eta 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 T YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING,CONSULT WITH YOUR LEN R TTO / TPRE
RECORDING YOUR NOTICE OF COMMENCEMENT /
(Sgnatue ofOwner c,Aprk) (Si I Contraaor)
Signed and sworn to(or affirmed)before me this 1�day of gned and swum to(or affirmed before m this r2day pf
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Type of Identification:
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