835 Sailfish Dr RERF21-0068 ShingleOWNER:ADDRESS:CITY:STATE:ZIP:
EILAND LUCILLE W 2031 FOREST GATE DR W JACKSONVILLE FL 32246
COMPANY:ADDRESS:CITY:STATE:ZIP:
FIRST COAST HOMES LLC 1719 10TH STREET NORTH JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171244 0000 ROYAL PALMS UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
835 SAILFISH DR REROOF SHINGLE Shingle: FL30310-R1,
FL17084.1 FL16160.1 $6500.00
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
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: 3/5/2021
PERMIT NUMBER
RERF21-0068
ISSUED: 3/5/2021
EXPIRES: 9/1/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 3/5/2021
PERMIT NUMBER
RERF21-0068
ISSUED: 3/5/2021
EXPIRES: 9/1/2021
REROOF SHINGLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $89.00
RERF21-0068 Address: 835 SAILFISH DR APN: 171244 0000 $89.00
BUILDING $85.00
BUILDING PERMIT 455-0000-322-1000 0 $85.00
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: R15111 $89.00
Printed: Friday, March 5, 2021 1:43 PM
Date Paid: Friday, March 05, 2021
Paid By: FIRST COAST HOMES LLC
Pay Method: CREDIT CARD 430190115
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15111
Building Permit Application
City of Atlantic Beach Building Department
Updated 10/9/18
ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHUGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
ddress 335 Sallfsh OtiveAtlaatic f Permit Number
Legal Description 3o-G02-2S-29E Aeyal Alas Unit 2 Let2e dk_REs 12/244- cocC Valuation of Work (Replacement Cost) $_hkoe, o Heated/Cooled SF CNon-Heated/ Cooled24S
Class of Work New Addition CAlteration Repair OMove CDemo OPool Window/Door
Use of existing/proposed structure(s) OCommercial Residential
If an existing structure, is a fire sprinkler system installed? OYes No
WItreela be removed in association with proposed proiect? Yes (must submit separate Tree Removal Permit No Describe in detail the type of work to be performed Re move/Replace asjhalt sh. 1gl e s
Fiorida Product Approval #tached to:m
Property Owner Information
Name LecI w.Eland
City ttlsatic rech
for multiple products use product approval form
Address35 Sa:Ltish De State / z Phone e- 453-o777 E-Mail A
Owner or Agent (1f Agent, Power of Attorney or Agency Letter Required) Contractor Information
Name of Company Eist Cest fopCS, 2L Qualifying Agent av sles CDoecv Address 1211 1e stert ec lk Office Phone cy-07-2 S/44 State Certification/Registrati on # CCCI33/5 SO_ EMaildodori 4 v @aal.com Architect Name & Phone #
Engineers Name & Phone #
City TGX sk
Job Site Contaçt Number SS?- 24 7
State FL Zip12<0
Workers Compensation Insurer
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
OR Exempt Expiration Date S742012
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.
(Signature of Ownér or Agent)
(Signature of Contractor)
Signed and sworn to (or affirmed) before me this day of Maich J03,
Signed and sworn to (or affirmed) before me this day of
4}LYSN DOERR
GtRATISsw GG 178343
My Commission Expires
January 24, 2022
teNEd 178343
My Commission Expires
January 24, 2022 Personally Known
U Produced ldentification
Type of ldentification fie;s _Ls.
IX Personally Known OR
Produced ldentification
Type of ldentification:
RERF21-0068