81 W 9th St ROOF20-0034 roof permitOWNER:ADDRESS:CITY:STATE:ZIP:
NOGUEIRA ANTONIO 81 W 9TH ST ATLANTIC BEACH FL 32233-3464
COMPANY:ADDRESS:CITY:STATE:ZIP:
Commonwealth Roofing
Co 8833 Perimeter Park Blvd Suite 1102 Jacksonville Fl 32216
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170813 0090 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
81 W 9TH ST ROOF NON SHINGLE SHINGLE ROOF $9500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $104.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 5/20/2020
PERMIT NUMBER
ROOF20-0034
ISSUED: 5/20/2020
EXPIRES: 11/16/2020
ROOF NON SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 5/20/2020
PERMIT NUMBER
ROOF20-0034
ISSUED: 5/20/2020
EXPIRES: 11/16/2020
ROOF NON SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
e Building Permit Application
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**All INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Address: 81 West 9th Street Atlantic Beach FL, 32233 Permit Number : __________ _
Legal Description 18-34 17-2S-29E .090 ATLANTIC BEACH SEC H W SFT LOT 4,E 34FT LOT 5 BLK 67 RE# __;;,17'--'0;;.;;;8.;;;.13;;..-0.;;.0;;.;;9;;.;;;0 ____ _
Valuation of Work (Replacement Cost)$ _______ Heated/Cooled SF _____ Non- Heated/Cooled ____ _
•Class of Work: □New □Addition IKIAlteration □Repair □Move □Demo □Pool □Window/Door
•Use of existing/proposed structure(s): □Commercial �Residential
•If an existing structure, is a fire sprinkler system installed?: □Yes □No
•Will tree/sl be removed in association with orooosed Droiect? □Yes (must submit seoarate Tree Removal Permitl □No
Describe In detail the type of work to be performed:
Re Roof
Florida Product Approval# ___________________ for multiple products use product approval form
Property Owner Information
Name Antonio Nogueira
City Atlantic Beach
E-Mail marcomoura1969@yahoo.com
Address 81 West 9th Street
State _FL __ Zip 32233 Phone __,.9""04..:.:2::..:4""66:a::9::.:3:.::.0 _______ _
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) ___________________ _
Contractor Information
Name of Company Commonwealth Roofing
Address 8833 Perimeter Park Blvd Suite 1102
Office Phone 9046601954
State Certification/Registration # RC29027663
Qualifying Agent Jesus Ramirez
City Jacksonville State FL Zip 32216
Job Site Contact Number---.,..,.-..,....---------
E-Mail stephanie@commonwealthroof.com
Architect Name & Phone# __,.;.n..,;;;.a ________________________________ _ Engineer's Name & Phone #---'n..;,..;;;a _______________________________ _ Workers Compensation Insurer OCMI 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,
WELL S, 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 ail 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 FINA NCING, CONSULT WITH YOUR LENDER 0 TTORNEY BEFORE
ENCEME N
I
9,500 2,202
FL10124R20 FL18686R2
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $104.00
ROOF20-0034 Address: 81 W 9TH ST APN: 170813 0090 $104.00
BUILDING $100.00
BUILDING PERMIT 455-0000-322-1000 0 $100.00
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: R13494 $104.00
Printed: Tuesday, September 29, 2020 4:11 PM
Date Paid: Tuesday, September 29, 2020
Paid By: Delia Mihaila
Pay Method: CREDIT CARD 382176687
1 of 1
Cashier: JJ
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R13494