1931 Francis Ave RERF20-0165 Shingle REROOF SHINGLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RERF20-0165
oi 800 SEMINOLE ROAD ISSUED: 8/31/2020
-~�r);;v.);• EXPIRES: 2/27/2021
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.
= OB ADDRESS:
n4PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
rte
1931 FRANCIS AVE REROOF SHINGLE shingle re-roof FL10124.1 $5600.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: `s NUMBER: GROUP:
172110 0010 DONNERS S/D PT LOT 2
17-
COMPANY: ADDRESS: CITY: STATE: ZIP:
Rhino Roofing of
Jacksonville LLC 9625 Hood Rd Jacksonville FL 32257
OWNER: ADDRESS: CITY: STATE: ZIP:
JRP 2019 LLC 4319 SALISBURY RD SUITE 108 JACKSONVILLE FL 32216
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 $80.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$84.00
Issued Date: 8/31/2020 1 of 2
I
rs'-tY1'% , REROOF SHINGLE PERMIT PERMIT NUMBER
r-,"
ei CITY OF ATLANTIC BEACH RERF20-0165
�\ r 800 SEMINOLE ROAD ISSUED: 8/31/2020
o;ii)r ATLANTIC BEACH, FL 32233 EXPIRES: 2/27/2021
Issued Date: 8/31/2020 2 of 2
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
;; - 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
% IS REQUIRED.
Phone: (904) 247-5826^, Email: Building-Dept(a�coab.us
Job Address: f (3( r%pA NC iS AVE. k ric ,SAN 3;1713Number: 0�P-r a B — d t ( s
Legal Description M-16 6 11-2.s-2C1'E.114 P.)NNEll$ er I'rLoTs 2 3 RE#
RECD 0/(2- fa 6-2367
Valuation of Work(Replacement Cost)$ 5;6(30 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New DAddition DAlteration DRepair ❑Move ❑Demo ❑Pool DWindow/Door
• Use of existing/proposed structure(s): DCommercial .'Residential
• If an existing structure,is a fire sprinkler system installed?: DYes ❑No
• Will tree(s) be removed in association with proposed prosect? ❑Yes(must submit separate Tree Removal Permit) .ZNo
Describe in detail the type of work to be performed: _ 'o G 1,-
Florida Product Approval# 101-1)A..¶ for multiple products use product approval form
Property Owner Information
Name --i-pp 20(otLi,C, Address 14314 3ALi s Bu>2V k' SUIr6 (oa
City TACtn'QNV, LLE State ft, Zip 522 / 6 Phone (loci -qcS — (,,(,3q-
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company TIA N() gOo Ei NJG Qualifying Agent
Address X625 1400P 12.D 3-74-y, r--t. 3t2r-7 City MtlyicSONVILL Cstate FL Zip 3e_2 s1
Office Phone R G4 — reK — C,4 y Job Site Contact Number ctdl{-s-oo-is 6;(4F31-
State Certification/Registration#GCC I S3 iii-] E-Mail e.H I?.JO 1 OO f-TA-N4 GM,Ri(•.COM.,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt dExpiration Date -117 I 17'022
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 OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. 1-aYvi\ \A \
(Signature of Owner or Agent) (Signature of Contractor) `')
Signed and sworn to(or affirmed)before me this,? day of Agned and sworn to(or affirp�ed) before me this / day of
4 ..i . 1t/.,byX / u.i ' - , Id7,0 ,byX
aper At Notary Public State of Florida , \�� �v` `/(h(Signature of Notary)
• Molivann Mer (Signature of Notary)
MY Commission GG 924463 fir,P\
NotaryPublic State of Florida
Nor rc� Exgrea 10/21/2023 Molivann Mer
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