1973 Seminole Rd RERF20-0187 roof repair permitOWNER:ADDRESS:CITY:STATE:ZIP:
REEVE JAMES 1973 SEMINOLE RD ATLANTIC BEACH FL 32233-5917
COMPANY:ADDRESS:CITY:STATE:ZIP:
HAMMER TIME ROOFING 14286 Beach Blvd JACKSONVILLE FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 0504 BEACHSIDE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1973 SEMINOLE RD REROOF SHINGLE SHINGLE ROOF REPAIR OF
550 sf $4500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $75.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $79.00
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: 10/13/2020
PERMIT NUMBER
RERF20-0187
ISSUED: 10/13/2020
EXPIRES: 4/11/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 10/13/2020
PERMIT NUMBER
RERF20-0187
ISSUED: 10/13/2020
EXPIRES: 4/11/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
. , Building Permit Application €,-.... s---_" .... ,": .. ,.· ....... ··"'··r City of Atlantic Beach Building Department
'<:,� 800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Buiiding-Dept@coab.us
Updated 10/9/18
** ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED.
Job Address: _f�'l_7..__._?�� .... Se ....... cn.:;.LA.:...,,..s<.tJu.i._e__,R,.:,,,,..d'-----------Permit Number: __________ _
RE# IGC/,'f'i'a -OSDY
Valuation of Work (Replacement Cost) $ _4,500.00______ Heated/Cooled SF ____ Non-Heated/Cooled
____ _•• Class of Work: □New □Addifion □Alteration �ir □Move □Demo □Pool □Window/Door
Use of existing/proposed structure(s}: □Commercial i:;a-rresidential
•If an existing structure, is a fire f prinkler system installed?: □Yes BNo
•Will trees be removed in assotiation ith ro osed ro·ect? □Yes must submi se arate Tree Removal Permit �Describeindetailt hetypeofworktob�perforrned: R.eMovL. 6SO sivM..-(.ed-¢( s.l.i-.�/...s, rc�ir°'-� t
['f.Pf�t.. 5 �4' !.._':, .
.:'.i :-..\ 't. Florida Product Approval #-1=,4-J��· l.!J..<��...µ:..J...!-"1.!el.L.¥..::../l:.+------for multiple products use product approval form
Property Owner Information Name�__c_h�s �!Address ...J./'--'9'-'7,._3.,___.S=e....c.l""-_,:.u:in"'E.�1-r-/,._( -..J..''R_,,_,'J..._ __ �---City �bt p,:;;£_ State Fl Zip :?a �1 3 Phone(Cfo4 i�£.io � �)""",[jE-Mail 7hy lf...e $ eo., t<\f,,....,,,, · / . v, &-,.. Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) __________________ _
Contractor Information Name of Company �? 7 ,,-T41 t; !00£�,,,t..,_ Qualifying Agent aalltM><f:. & Lcak:<C f Address I qd: 8 <ti &:M.k.-1JkJ s_}L I�-Ylft; \City � )0 State FL Zip 3 aa;r-o Office Phone C1D '-i 1 714 -'fl 'I 'i ; Job Site Contact Number f!Ol.,f l a <10 -�s S: '::1 State Certification/Registration ncu I J 4, 'tct cf? E-Mail �t>io v:b'""< ao t te!? 6 oe,: I. Co&:, Architect Name & Phone# _________________________________ _ Engineer's Name & Phone# ________________________________ _ Workers Compensation Insurer ___ _;_ ___________ 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 understc1nd 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 R PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAI ULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDr OMMENCEMENT. � /=--a-------
(Signature of Contractor)
MPersonal!y Kr.own OR f ] Produced Identification Type of Identification: __ __..-\-¼ -.,� ...... ��efflB<.,.u.,,.-=�
o( Personally Known OR •••• �•::••,,,.. CARMEN E PEET ( ] Produced Identification f•: l MY COMMISSION# GG 956962Type of Identification: ---�""'�t�24
I$
RERF20-0187
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $79.00
RERF20-0187 Address: 1973 SEMINOLE RD APN: 169542 0504 $79.00
BUILDING $75.00
BUILDING PERMIT 455-0000-322-1000 0 $75.00
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: R13794 $79.00
Printed: Tuesday, October 13, 2020 4:35 PM
Date Paid: Tuesday, October 13, 2020
Paid By: Anthony Betancourt
Pay Method: CREDIT CARD 385977791
1 of 1
Cashier: JJ
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R13794