314 3rd St RERF19-0137 Shingle rs REROOF SHINGLE PERMIT PERMIT NUMBER
5) 1.1," *
"`' CITY OF ATLANTIC BEACH RERF19-0137
,r ISSUED: 10/7/2019
' v
800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 4/4/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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:
314 3RD ST REROOF SHINGLE SHINGLE ROOF (400 SQ FT) $2200.00
TYPE OF REAL ESTATE j ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169779 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: I STATE: ZIP:
HAMMER TIME ROOFING 14286 Beach Blvd JACKSONVILLE FL 32250
OWNER: I ADDRESS: CITY: j STATE: I ZIP:
PINKSTAFF KEVIN JOHN 314 3RD ST ATLANTIC BEACH FL 32233-5232
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 PERMIT 455-0000-322-1000 0 $65.00
STATE DBPR SURCHARGE 455-0000-208-0700 ▪ 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 • 0 $2.00
TOTAL: $69.00
Issued Date: 10/7/2019 1 of 1
'tL''%., Building Permit Application Updated 10/9/18
�v, City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
-ult te IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us j� (� /�
Job Address: �`)7 1G '5( C� S`Ce f' t',J, ) Permit Number: 1 � C-R E 1 9 -0 l 67
Legal Description(9 1 )6-3)5.....)`)L--. 1I) `�`i he ac 1 Lot S i3 ( RE#
Valuation of Work(Replacement Cost)$ I t)4 0 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New Addition ❑Alteration gf(epair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial I' tesidential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s) be removed in association with proposed proiect? ❑Yes(must submit separate-Treelj Removal Permit) ❑No
Describe in detail the type of work to be per orme \ V l .er- m A
- ,),.. -''.4%,,, ,,.. i/p, (' Lio o i 1 f:
Florida Product Approval# l01'Pi"kel!)- r4qc 10144313 for multiple products use product approval form
Property Owne Information / .t yr5;:::=
Name � ,.1% Address S ILI �rci S
City ,44/c,n-\1C r`74-C t State L Zip 3 3 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information n
Name of Company J-J'rt't 4 limy X` t.-4' Qualif ing Agentffnc1 ( l
Address)'-1-3�j & 1 c m 4�d IP City Lc 1 4 , jeil kh St to `-t Zip 3-;C)
Office Phone ( t>-I ) `7I 6'- cdqu) Job Site Contact Number
State Certification/Registration# CC( )3 3 c64ic 3 E-Mail
Architect Name&Phone#
Engineer's Name&Phone# p
Workers Compensation Insurer ds1 ieke CON.tat 1 OR Exempt❑ 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 FINANCING, CONSULT WITH YOUR LENDER 0• A.N ATTOR - BEFORE
RECORDIN2UR NOTICE OF COMMENCEMENT. 04111,Pri ....--
(Signature of Ow er or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)befor- me this S •ay of ne and sworn to a' �d)before m- th's 7day f
due-
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A.FLORES ppr
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i..,`r0 Notary Public,State of Florida �it e of Notary) I ign• • atry) '
F Commission#GG 328087 �
'r My comm.expiresApr.25,2023
`--71 Pers no airNiRno-Wn OR [ ersonally Know Q5 # MY OMMISSION#GG3S3178
[ ]Produced Identification [ I Produced Identi 1:,%!4:,„„.P`F EXPIRES:October 6,2023
Type of Identification: ( e of Identificatio '`EOF,`? Bonded PubliicUndenwitters
YP \�`� `,�vr8 L ��Go-rte G Type ��Y
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