275 5th St RERF20-0118 ShingleOWNER:ADDRESS:CITY:STATE:ZIP:
KUBIAK LAVINIA HARVEY
LIVING TRUST 275 5TH ST ATLANTIC BEACH FL 32233-5311
COMPANY:ADDRESS:CITY:STATE:ZIP:
TOWNSEND ROOFING &
CONSTRUCTIONS SERVICE 10418 New Berlin Rd #115 JACKSONVILLE FL 32226
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172558 0000 ATLANTIC BEACH
TERRACE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
275 5TH ST REROOF SHINGLE SHINGLE ROOF $12830.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $115.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $119.00
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: 6/24/2020
PERMIT NUMBER
RERF20-0118
ISSUED: 6/24/2020
EXPIRES: 12/21/2020
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/24/2020
PERMIT NUMBER
RERF20-0118
ISSUED: 6/24/2020
EXPIRES: 12/21/2020
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $119.00
RERF20-0118 Address: 275 5TH ST APN: 172558 0000 $119.00
BUILDING $115.00
BUILDING PERMIT 455-0000-322-1000 0 $115.00
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: R12155 $119.00
Printed: Wednesday, June 24, 2020 10:01 AM
Date Paid: Tuesday, June 23, 2020
Paid By: TOWNSEND ROOFING & CONSTRUCTIONS SERVICE
Pay Method: CHECK 191
1 of 1
Cashier: CT
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R12155
RERF20-0118