1003 Jasmine St RERF19-0057 Shingle S REROOF SHINGLE PERMIT PERMIT NUMBER
m CITY OF ATLANTIC BEACH RERF19-0057
800 SEMINOLE ROAD ISSUED:4/24/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 10/21/2019
INSPECTIONMUST CALL • • t , FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt OF • • D• BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1003 JASMINE ST REROOF SHINGLE SHINGLE ROOF $7640.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1709910010 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
BIGFOOT ROOFING & 615720 RIVER RD CALLAHAN FL 32011
CONSTRUCTION
• ADDRESS:
WERNERFRANK 1003 JASM INE ST ATLANTIC BEACH FL 32233-1816
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
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 CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PE0.MIT 6550000.322-1000 0 $9000
STATE DBPR SURCHARGE 4550000208-0J00 0 $200
STATE OCA SURCHARGE 455-MW-2080600 0 $2,00
TOTAL:$94.00
Issued Date:4/24/2019 1 of
Cash
Nuer
1City Register • 1 Atlantic Beach , 1
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DESCRIPTION
PermitTRAK - $94.00
RERF19-0057 Address: 3003 JASMINE ST APN: 170993 0010 $94.00
BUILDING $90.00
BUILDING PERMIT 455-0000-322-1000 0 $90.00
STATE SURCHARGES $4.00
STATE DEER SURCHARGE 455-0000-208-0]00 0 $2.00
STATE OCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL1 $94.00
Date Paid:Wednesday,April 24,2019
Paid By: BIGFOOT ROOFING &CONSTRUCTION
Cashier: CT
Pay Method: CREDIT CARD 09549G
Printed:Wednesday,April 24,2019 30:18 AM 1 Of I
Building Permit Application updated 10/y/18
City of Atlantic Beach Building Department "ALL INFORMATION
p 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-DeotlIdDcoab.us `` IS REQUIRED.
lob Address: f00({ JwsA.YN! Sr. Permit Number: INC M1F 1") - C ( LJ /
Legal Description)JI*IW SE�2S+21E .0 AFLAn"faAa tae Y L,iY M0.Elf 1TO411 -0Ofo
Valuation of Work(Replacement Cost)$ 71A •O 0 Heated/Cooled SF Non-Heated/Cooled_
• Classof Work: []New, OAddition []Alteration f((iepair OMove []Demo OPcol []Window/Door
• Use of existing/proposed structure(s): OCommerclal *esidentlal
• If an existing structure,is afire sprinkler system installed?: Ores ONo
• Will r removed in assoclation wal r d r e 7 DY [ u m' r t Tr R m P rmi 40
Describe In detail the type of work to be performed: Tj;AR Off" 11n-R ddf SySM6L -:12122 S@
G OVl ( FLIb(o8 -R3
Florida Product Approval a FL. 1012 It. R 19 1
for multiple products use product approval form
Property Owner Information
Name Address 1003 L7AfNYd� -sTRRfT
City Stater�zip�7Z13 Phone (241 YCroVI
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor information
Name of Company 6SANOT RMt1ML 1 CaarANenrquali(ying Agent
AdcityolikekLL'aAnau.1 StatePi— _Zip 90
Office Phone tail9e'j� lab Site Contact Number
State CertifiwT/Registration#LLL12ZIi E-Mail'Afi OLy�•M�. S... saw
Architect Name&Phone a
Engineer's Name&Phone g
Workers Compensation Insurer Ji SA OR Exempt O Expiration Date
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 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,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 FI ING, (bf)I$ULT IMOUR LENDER OR AN ATTORNEY BEFORE
RECORD! T M EMENT. 1
ae
(signature of Owner or Agent) (Signature of Contrx or) qyE ss
fa
Signed and sworn to(or affirmed)before methis day of Signed and sworn to(or affirmed)before me this day
AjR2L 40/9 ,by !<AsY I! Ls/�aJIYfA A1Ar4 tf/el .by
Signatureof Notary) Signature of Notary)
NaM/PuMc SbM d Fd•d•
( I Personally Know �aPhama H°R'"an )persomlly Known O 416h. �'aF • a
Produced ld6ntl My Caw!w•im OG araaJ9 My allok.••erl
aryYYOlglnab I1ProducM blentifcati / Mr,.. :r .rm nG aU0.la
Type of Identifiuri Type of Idendpcatlon: `.J Emm oumnc"s
Doc # 2019091404, OR BK 18764 Page 27, Number Pages : 1 ,
Recorded 04/22/2019 12:56 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
(PPEYMF w ouKII
Pxma No. Te[Folio No. 170N14)010
Snte Ml FlonZe Cowtyof_ Duval
To Whom N nary oonwm:
soxondan"With Slaxxllwo 713of sFlyoodutlMa Sa[bIlmuplam,vMomceIMnlIo WW8h1pMFNmoommatloon IlacstatedlI.this NNOTICE
IOFCOMMENCEMENT.
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rCash Register Receipt1 1 •
.n
City of Atlantic Beach R8858
DESCRIPTION ACCOUNT CITY PAID
J°
PermitTRAK $55.00
RERF19-0057 Address: 3003 JASMINE ST APN: 1709910010 $55.00
ROOF DRY IN 04/25/2019 RBE $55.00
ROOF DRY IN 04/25/2019 RBE 1 45500003221002 0 $55.00
TOTALa 11
Date Paid:Thursday,April 25,2019
Paid By: BIGFOOT ROOFING &CONSTRUCTION
Cashier:CT
Pay Method:CREDIT CARD 041386
Printed:Thursday,April 25,2019 4:22 PM 1 of 1