1490 Ocean Blvd RERF20-0113 ShingleOWNER:ADDRESS:CITY:STATE:ZIP:
FINDLEY ROBERT D 1490 OCEAN BLVD ATLANTIC BEACH FL 32233-5746
COMPANY:ADDRESS:CITY:STATE:ZIP:
SCHULTZ ROOFING
COMPANY INC 216 N 20TH ST JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171856 0000 MANDALAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1490 OCEAN BLVD REROOF SHINGLE SHINGLE ROOF $8500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $95.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 6/18/2020
PERMIT NUMBER
RERF20-0113
ISSUED: 6/18/2020
EXPIRES: 12/15/2020
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/18/2020
PERMIT NUMBER
RERF20-0113
ISSUED: 6/18/2020
EXPIRES: 12/15/2020
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
RERF20-0113 Address: 1490 OCEAN BLVD APN: 171856 0000 $99.00
BUILDING $95.00
BUILDING PERMIT 455-0000-322-1000 0 $95.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R12132 $99.00
Printed: Thursday, June 18, 2020 2:52 PM
Date Paid: Thursday, June 18, 2020
Paid By: SCHULTZ ROOFING COMPANY INC
Pay Method: CHECK 11333
1 of 1
Cashier: CT
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R12132
��S!J"'1r1.(,> Building Permit Application € � ...... J� City of Atlantic Beach Building Department .. J, 800 Seminole Road, Atlantic Beach, FL 32233 I, tJ;tH)n Phone: {904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Address: 14 qo Oc.ea.n f31vd IJ--1(. f?:x..,h Permit Number: _________ _
Legal Description /0-11 /{q -d S -d9E Mll:NOA-l A.:V l or RE# / 7 I 8$� -0000
Valuation of Work (Replacement Cost)$
1
Heated/Cooled SF {P ✓/3/K ��-Heated/Cooled·-----
•Class of Work: □New □Addition □Alteration □Repair □Move □Demo □Pool □Window/Door R €--Roo-9
•Use of existing/proposed structure(s): □Commercial ')liResidential
•If an existing structure, is a fire sprinkler system installed?: □Yes □No
•Will treelsl be removed in association with nronosed nroiect? □Yes /must submit seaarate Tree Removal Permit\ □NoDescribe in detail the type of work to be performed: () +-ta...\-\ e o -f -f o \ ol ( o o -f- � , u.: 0 'f\ (\e_LL)
Florida Product Approval # b,'\,f'(\��< li/1/'e.-+ L-# /0 I� V-for multiple products use product approval form
Property Owner lnformatio1riG�f'lr���\i !ti.,1:-J1�q--? 1
Name Rohect t). Fi"d \:e.'f Address l'l90 Ocea..n B\vd
City A+la..n+•'c.. Be-er. d:-:-State F( Zip ,3'cid.3� Phone ___________ _ E-Mail-'---'---------------------------------------' Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) __________________ _
Contractor Information
Name of Company Scb u.. i t2= R.ooh'n.5 � .Inc. Qualifying Agent Ooua/4 � Sr h lL If 2,,,Address c?, / (a JIJ. � � ..C:1:::, Citv;r,1-x f3 c b State El Zip 3 ;>2 S:9 Office Phone & Y,(o -� 3 J S-Job Site Contact Number 2 15"9 -Q O � 3State Certification/Registration# C.C-C.0,;>,98'7 E-Mail Sch CQQ t·�3 , ,- � ya..ht>o. c.ir-----Architect Name & Phone# _________________________________ _ Engineer's Name & Phone# _-=---,---,------...,....,=-r=-..-=---------------------Workers Compensation Insurer ::lm()qc f Sfqf'P Le 4'S ,� �J>j1.'t>170R Exempt □ Expiration Date 8-15 �dOclOApplication is hereby made to obtatn a permit to do the wo�fand 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.
WARNI NG TO OWNER: YOUR FAILUR E TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYI NG TWICE FOR IMPROV EMENTS TO YOUR PROPERTY. IF YOU I NTEND
TO OBTA I N FINANCING, CONSULT WITH YOUR L END ER OR AN ATTORNE Y B E FORE
REMIN� y��tyJgTICE OF COMMENCEMEN_T_. --=·�11'::::=--"')"-------------=---�wner or Agent) (Signature of Contractor)
Signed and sworn to (or affirmed) befo e me this J.L day of
½&,..(.1 _2.02-o t 'T' ROBIN c. MOORE •• , •• ,. •• _ :\... / f.,f ·:•1 MY COMMISSION# GG 3595S5 ,��--�-, ROBIN C. MOORE
Lf'i.,Personally Known OR ll1.•··· 0f/ EXPIRES: July 28, 2023 I Personally Known OR fa{�):} MY COMMISSION# GG 359585
[ ) Produced ldentifica-tio_,��-:_·••-l:5f_,r'ii;,
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':_iiiBonded
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ThlU��Nolary����Pu-::bli_ic�Undelwr1tera�;_:;_�:JI [ ) Produced Identification -.,'!,�-.... 0�/ EXPIRES:July28,2023 ····l:l'.r.i•··· Bonded ThlU Notary Public UndeR....,e-Type of Identification: Type of Identification: ___ _J�ifiiiiiiiiiiiiiii�����=•"="'••:JI
8,500.00