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91 W 11th St #800 RERF19-0110 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER ad RERF19-0110 CITY OF ATLANTIC BEACH 8 ISSUED: 8/28/2019 00 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 2/24/2020 MUST CALL INSPECTION • • 91 + 247-S814 BY + PM FOR NEXT DAY INSPECTION. ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' i ► BUILDING CODE, NEC, IPMC, AND CITY OF • i OF ORDINANCES . ALL • i • OF PERMIT APPLY, PLEASE READ 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: 91 W 11TH ST REROOF SHINGLE BUILDING #800 - SHINGLE $22970.00 ROOF TYPE OF ZONING: :D • CONSTRUCTION: GROUP: 170807 0000 ATLANTIC BEACH SEC H COMPANY: ADDRESS: CITY: STATE: ZIP: a ALL WEATHER 7749 Normandy Blvd. #145-347 Jacksonville FL 32221 CONTRACTORS INC • ADDRESS: STATE: EMPIRIAN DRIFTWOOD C/O ELON PROPERTY MGMT LAKEWOOD NJ 08701 LLC 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. 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 PERMIT 455-0000-322-1000 0 $165.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.48 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $169.48 Issued Date: 8/28/2019 1 of 2 Building Permit Application VndMa,WWM City of Atlantic Beach Building Department '•ALL lNFOil!%IW7 DN;. u 800 Seminole Road,Atlantic Beach, FL 32233 N16t+ }6HTEdMlGR/1Y . Phone:(904)247-5826 Email: Building-DeAt�caab us 1sREa Job Address: t p f 111E 'eie t/ ivllA►11:2 .1*rmitNumber. `-\ E' F 1 9 - 0110 Legal Description , • R E# ..� Valuation of Work(Replacement Cost � $ Nested/Cooled Sf Non-Heated/Cooled o Class of Wm*: ONew ❑Addition ©Alteration),3�epair OMove ODemo ❑Pool QWindow/Door ° t.fse of ex!Zng/proposed structure(sy OCommerciai Residential ° If an existing structure,is a fire sprinkler system installed?: lef�es CJNo ° l e remo=Q in a' Ts Re P N Describe iii detail the type of work to tw perfasmed �j. Florida Product Approval# O for multiple products use product approtrat form Pro er caner Infmm 'on Nam IL- City ddress � E-Mail .C�State Zip��,Phone Owner or Agent(If Agent,Power o Attorney or Agency Letter RegWred) co ra s Irfarm n t Name of Com an dual' 'ng Agent Address 5tdte - Iip --- Office Phone Job site Cont N tuber State CerttCtcation/Registration; �/S-t0��,'—•E�Mai} Architect Name&Phone it ` Engineer's Name&Phone# Workers Compensation Insurer OR Exempt❑ Expiration Date " Application is hereby made to obtain a permit to do the work and installations as Indicatedt,t certify that no work or i=allatlon 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 PWMBING SIGNS, WELLS POOLS FURNACES,BOILERS,HEATERS,TANKS and AIR CONDMONERS,etc. I46* .In addition to the requirements:tif this permfZ;vsere maY tie addltldnal restrictions appii�ab[r to this pro iierty that iaay be found 2n the ptttifc records ofthis county,and there may.J3e ddlttanal permits required Tromotlt;crvetnmtirgal_entatiesScch as,uriter:mar agement cloricts,state age haesrds feaerat,age�es OWNER'S AFFiDAVrf:I certify that all the foregoing information is accurate and that aU work will be done In rompt;ance with all appilcable laws regulating construction and 2onhig, 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 013TAIN FINANCING,CONSULT WITH YOUR LENDER OR N ATTORNJY BEFORE SEC INC YOUR NOTICE OE' COMMENCEMENT. (signature o Owner tx Agertil` (*na1 tuture of contractor) Signed and sworn to(or a )before this :Jay of Sigoed and sworn to(or affirmed),before me this y of (Signature o.►ar goo` Notary Puulic State of Florida .a`a"OG Notary P ta;c cratesrate or r : Wgirtta J outlin er v1/1L. ally Kno aR, ^, Virginia J Outtinger [personally Known On y My Canrnlsa on GG 118272 I i Produced a a My Commission GG 119272 �"I It, Expires 1012012021 t �[ ;rProduced Identification +; T?,pe of IderLiftott Fol r Expires io120/2021 Type of Idenirflratlon: J r j Cash Register • , Receipt City of Atlantic yr Beach R10311 DESCRIPTION • QTY PAID PermitTRAK $55.00 RERF19-0110 Address: 91 W 11TH ST APN: 170807 0000 $55.00 ROOF IN PROGRESS 09/16/2019 MJ $55.00 ROOF IN PROGRESS 09/16/2019 MJ 455-0000-322-1002 0 $55.00 TOTAL1 11 Date Paid: Tuesday, September 17, 2019 Paid By: ALL WEATHER CONTRACTORS INC Cashier: CT Pay Method: CREDIT CARD 035078 Printed:Tuesday,September 17, 2019 9:42 AM 1 of 1