315 2nd St RERF19-0167 Shingle over Shingles A:1'------'''''i-7,,,, REROOF SHINGLE PERMIT PERMIT NUMBER
,.eil .. _• : CITY OF ATLANTIC BEACH RERF19-0167
`Jr V~ 800 SEMINOLE ROAD ISSUED: 11/19/2019
'� °ls 9" ATLANTIC BEACH. FL 32233 EXPIRES: 5/17/2020
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
315 2ND ST REROOF SHINGLE SHINGLE ROOF OVER $6977.00
SHINGLES
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169779 0010 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
HANSON ROOFING INC 2765 Leon RD JACKSONVILLE FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
DSM RENOVATIONS LLC 1433 PONTE VEDRA BLVD PONT: VEDRA FL 32082
BEACH
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
„ FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $89.00
Issued Date: 11/19/2019 1 of 2
31' 1.A0,, REROOF SHINGLE PERMIT PERMIT NUMBER 1
is,
CITY OF ATLANTIC BEACH RERF19-0167
800 SEMINOLE ROAD ISSUED: 11/19/2019
'' ATLANTIC BEACH. FL 32233 EXPIRES: 5/17/2020 I
Issued Date: 11/19/2019 2 of 2
�y Application
Building Permit Application updated
City of Atlantic Beach Building Department *=ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 24T5826 Email: 6uiiuirig-uept@-icoab.u:
Job Address: 315 2nd Ste. + \antic_aeacv, ,F L 32233 Permit Number: RGRF9_ 01 G7
Legal Description 6'4,9 1la'Z5 2GI RV\CAla � U
hC �ec� -E Z \ t (o L .c 10-41 RE# \(. Tic-L-0010
7
Valuation of Work(Replacement Cost)$ C# 79 Heated/Cooled SF Non-Heated/Cooled _
• Class of Work: DNew DAddition D3;Alteration DRepair DMove i_IDemo ❑Pool DWindow/Door
• Use of existing/proposed structure(s): OCommercial tesidential
• If an existing structure,is a fire sprinkler system installed?: DYes DNa
• Will tree(s)be removed in association with proposed project?DYes(must submit separate Tree Removal Permit] _-No
Describe in detail the type of work to be performed: ^o \ '
Florida Product Approval# (OL:7 LI "K t — for multiple products use product approval form
Property Owner Information
Name DI.-1‘ Address 433 •?onfie Ve-Ak(a k-)1 vcl • y
City S�(1 Ve l'�ro SCA Ch —State F L Zip 32'6G 2 Phone i
Q �{ - fj -QD 3 7
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) ---
Contractor information
Name of Company 1-\at1S oY1 \-WYCi nC.), I() . Qualifying Agent Y-eNI Nrt1-15OY-1
Address 2:11,0 5 12,01,-\ IZd City JQct,csanv i 1)e State r L Zip z12 2 LI (o
Office Phone (liOu- ,7Z3'gQ(ot-1 _Job Site Contact Number CCU-I- 533-SIO(9
State Certification/Registration# SLG. 0 5 I .5 E-Mail •' • .r. •\n T .. ' Cit-+
Architect Name&Phone#Engineer's Name&Phone#
Workers Compensation Insurer— OR Exempt expiration Date I 3 0 r
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 YO LI E OF
Vi OMMENCEMENT,
I Ag
ture of Owner or Agent) Lure o Contractor)
_
igned .•• • orn to(or affirmed)before�methis 11)- day of Signed and sworn to(or affirmed)before/ me this t 3 day of
l lat-15 C A/00 , ("`,by )e-f-(( -4',^
•d'pY P( �.• i_+•JENNIFER JOHNSTON , /11111111111111110
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MY COMMISSION#GG 042984 I) Si: ure o ary) (Sig re of Notary)
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- '°"" • EXPIRES.October 2i,2020
Bonded Thru Notary Public Underwriters
�• ow S• 1 I Personally Known OR JOHNATHAN FORD
(g_Produced Identification Commission#GG 159682
f t],Produced Identification
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ype of Identification: •••, •-.•a; ber 14,2021
°``•`�° Bonded Thru Troy Fain Insurance 800-36