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1043 Big Pine Key RERF20-0005 Shingle r,'y''`'r, REROOF SHINGLE PERMIT PERMIT NUMBER °' r, CITY OF ATLANTIC BEACH RERF20-0005 ISSUED: 1/23/2020 �� 800 SEMINOLE ROAD EXPIRES: 7/21/2020 442,01119'f' ATLANTIC BEACH. FL 32233 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: 1043 BIG PINE KEY REROOF SHINGLE shingle re roof FL10674.1, $11000.00 19948, 15592.6, 6267 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172027 5078 SELVA LAKES COMPANY: ADDRESS: CITY: STATE: ZIP: JACK C. WILSON ROOFING 4522 ST AUGUSTINE RD JACKSONVILLE FL 32207 CO. OWNER: ADDRESS: CITY: STATE: ZIP: FAULKENBERRY PHYLLIS 8725 COUNTRY GLEN CROSSING PLANO TX 75024 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. FEES DESCRIPTION ACCOUNT 1 QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $110.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $114.00 Issued Date: 1/23/2020 1 of 2 s� v'�J REROOF SHINGLE PERMIT PERMIT NUMBER s, RERF20-0005 CITY OF ATLANTIC BEACH ISSUED: 1/23/2020 J " 800 SEMINOLE ROAD .`Ji39r ATLANTIC BEACH. FL 32233 EXPIRES: 7/21/2020 Issued Date: 1/23/2020 2 of 2 (4' Building Permit Application Updated 12/8/17 "'�1,1 City of Atlantic Beach ti ! 800 Seminole Road,Atlantic Beach,FL 32233 ILA tt Phone:(904)247-5826 Fax:(904)247-5845 Job Address: IV� )t l iY VI {�lla. i[.�wc1n (( 3223:1 Permit Number: 2-c (1--F0& — coos- JJ 1. � Legal Description c{(- S' t'-Z S•2961 SA 0, 1,44(e. ?,Q, RE# vl Z C i-7 - Sege Valuation of Work(Replacement Cost)$ _ A t01eated/Cooled SF Non-Heated/Coo et! • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Do .-Ccs • Use of existing/proposed structure(s)(Circle one): Commercia slderrtial- • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail thype of work to be performed: e - Coo ...ff Florida Product Approval 11 iVp (y•.IJ 6cl` (..k.,.) lsyy2 (r) 1..,... k I- for multiple products use product approval form Property 07 I formation t_ f, Name: _ �,�L1 \ kik-q..-r16t.:Ci• Address: l�r %tk ',tr-Q.-• (,C',,• s• City OLjry. St to \L.- Zip 3._14,- Phone �J1 - l`('i,a E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: .)c-c.l,- 6.u-);6n ;Z C• Lo Qualifying Agent: C if,5fa9Lr' VOSS Address 61 c 22. . 1-. ;. Acu •,Ati...e A . City ,j.>.)e StatettEL Zip 3'Zld7 Office Phone c. CV- 3 rl (r,)• t S"N., Job Site/Contact Number State Certification/Registration# C.C..C_- 1.3 7C'1 i(rr E-Mail ) Lc-L.) '''C'6:-? je._,, -,- , cc;L, Architect Name&Phone# Engineer's Name&Phony Workers Compensationtit..,:c am,., Zu r,c- hs . (,, W1.%. '']o et' -f',if; -o‘j exp. 12 ,?( l 2ci Exempt/Insurer/Lease Employees/Expiration Date 1 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 RE • •RMNG YOUR OTICE OF COMMENCEMENT. (--)0 / ' 1 — i Amts `.4 s of b4 - (Signature of Owner or Agent (Signature of Contractor) u.15 m �, (including contractor)--- d and sworn to(or affirmed)before m- this day of ,Signed and swot to(or affirme.• befor- me this I)d. 4 e g@ 14... ZoL ,by i"S ��1. ` r 1w�.�t_r L)-c, ,by , vim• u. a U i JJU • W - :nature of ary) igna of otary) z ti je• . rsonally Known OR Personally Known OR /T „%►i iit' oduced Identification [ ]Produced Identification rj t .r4p. of Identification: Type of Identification: i�0yy Selva Lakes Homeowners Association, Inc.c/o Selva Lakes Homeowners Association, Inc. P.O. Box 331365 Atlantic Beach, FL 32233 Customer Care: Fax: Website: selvalakes.com Date: January 28, 2020 Project Ref: [27414978] 1043 Big Pine Key Phyllis Faulkenberry & Rick Dorn 1043 Big Pine Key Atlantic Beach F FL 32233 Dear Phyllis Faulkenberry & Rick Dorn, I am pleased to inform you that the Selva Lakes Homeowners Association, Inc. Architectural Committee has approved your application for the listed project item(s): Roofing - Band - paint Benjamin Moore Seagull Grey The approval is contingent upon compliance with the specifications set forth in the approved application.If your change or addition requires a county, city or state permit, it is the responsibility of the homeowner to obtain this before starting construction. Please do not reply to this message. If you have any questions or need to provide additional information, please e-mail us at arcsla@gmail.com. Sincerely, The ARC Committee Selva Lakes Homeowners Association, Inc.c/o Selva Lakes Homeowners Association, Inc. P.O. Box 331365 Atlantic Beach, FL 32233 Customer Care: Fax: OFFICE COPY Website:selva akes.om Date: January 28, 2020 Project R f 274149 BUILDING e . [ 78] 1043 Big Pme Key APPROVEDEPARTMENT D Phyllis Faulkenberry & Rick Dorn 1043 Big Pine Key Atlantic Beach F FL 32233 Dear Phyllis Faulkenberry & Rick Dorn, I am pleased to inform you that the Selva Lakes Homeowners Association, Inc. Architectural Committee has approved your application for the listed project item(s): Roofing- Band - paint Benjamin Moore Seagull Grey The approval is contingent upon compliance with the specifications set forth in the approved application.If your change or addition requires a county, city or state permit, it is the responsibility of the homeowner to obtain this before starting construction. Please do not reply to this message. If you have any questions or need to provide additional information, please e-mail us at aresla@gmail.com. Sincerely, The ARC Committee SCQYl /niv QC'o4 r1' lrveni1- CannPc1 -1v --1 hi .s I-R C RF2 0 - bcoS f^',1- c /y/d U Y , s �'I r-----1.-- . 1 , 165c-ii11.--, f 1 1 1 % ° r ___' VIgt,' "VPril! I ! 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