525 N Nautical Blvd RERF21-0076 ShingleOWNER:ADDRESS:CITY:STATE:ZIP:
MACADANGDANG WILMA
V 525 NAUTICAL BLVD N ATLANTIC BEACH FL 32233-4118
COMPANY:ADDRESS:CITY:STATE:ZIP:
MODEL CITY ROOFING dba
Roofing Alliance 5151 SUNBEAM RD #12 JACKSONVILLE FL 32257
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170703 0294 SEASPRAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
525 N NAUTICAL BLVD REROOF SHINGLE Shingle: FL20310 $12025.00
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: 3/11/2021
PERMIT NUMBER
RERF21-0076
ISSUED: 3/11/2021
EXPIRES: 9/7/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 3/11/2021
PERMIT NUMBER
RERF21-0076
ISSUED: 3/11/2021
EXPIRES: 9/7/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Job Address:
Building Pei-mit Application
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: E±±ilslinfipsp±@£Qabi±±S
LegalDescriptionggJSSRESREapjREsn:ngSS;RESRE.se`r#:vSE#§ELBTffiB
Valuation of Work (Replacement Cost) S
• Classof work: ENew EAddition HAlteration
Heated/Cooled SF
¢R
Permit Number:
Updated 10/9/18
\15u Non-Heated/Cooled
epair HMove EDemo EPool Ewindow/Door
• Use of existing/proposed structure(s): HCommercial %Residential
• lfanexistingstructure,isafiresprinklersysteminstalled?: EYes ENo
...., `..```. j`L`..` `. '..-' ...- ` ..,,.., `.". ,`.-.' ..,.,.,`..
Florida Product Approval #
Architect Name & Phone #
for multiple products use product approval form
Engineer's Name & Phone #
Workers Compensation Insurer OR Exempt g!{ 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
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
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
-.'-.'.:-.,---:_:'..iE'..ii_...___i__:i_i=i='_'!j__-._____!¥
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IKO SHINGLE FL PRODUCT APPROVAL CODE FL30310
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $119.00
RERF21-0076 Address: 525 N NAUTICAL BLVD APN: 170703 0294 $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: R15158 $119.00
Printed: Thursday, March 11, 2021 11:36 AM
Date Paid: Thursday, March 11, 2021
Paid By: MODEL CITY ROOFING dba Roofing Alliance
Pay Method: CREDIT CARD 432227334
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15158