320 Beach Ave RERF21-0198 Replace Drip Edge Flashing friiiH: -.Aj‘j'71e-,-.,. REROOF SHINGLE PERMITPERMIT NUMBER
RERF21-0198
CITY OF ATLANTIC BEACH ISSUED: 8/3/2021
800 SEMINOLE ROAD
-93wATLANTIC BEACH. FL 32233 EXPIRES: 1/30/2022
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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: I PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
320 BEACH AVE REROOF SHINGLE Replace Drip Edge Flashing $9500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170179 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
JVI Construction Group 10266 Jolynn Road Jacksonville FL 32225
OWNER: ADDRESS: CITY: STATE: ZIP:
Alan Pitts 320 Beach Ave Atlantic Beach Fl 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\
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.
LIST OF CONDITIONS
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 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$104.00
Issued Date:8/3/2021 1 of 1
w,7- -: Building Permit Application Updated 10/9/18
J
Y City of Atlantic Beach Building Department **ALL INFORMATION
-- u'' 800 Seminole Road, Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone:r� (904) 247-5826 Email: Building-Dept@coga.�b.us'
Job Address: �`�V �.J�J7V"„ \ r�V �41,4401(��P rim Number:
Legal Description S' o no- 2s ` 1-E ' 4& {fit t o f //L RE# 17 o f7 7 -4160o0
Valuation of Work(Replacement Cost)$ : /500 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration Aepair ❑Move ❑Demo ❑Pool ElWindow/Door
• Use of existing/proposed structure(s): ❑Commercial iesidential
• If an existing structure, is a fire sprinkler system installed?: , Yes ❑No
• Will tree(s) be removed in association with pro osed project? ❑Yes(must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed: ,er?\ctCrf 'pr) ) w'QCp T 1etsi
111 "' ` `J' 1 '"` ]
Florida Product Approval# for multiple products use product approval form
Property Owner I i formation 2 ,�
Name tq 1 e Address 3� b� �t�27t•,�J�C ',•,',' t-- zziJ2
City tev IC- D•��•t,�1 State Fl— Zip 374a) Phone 1' ai
E-Mail A QY1.f1-4S 07 Ccs-401-•Nc-J-
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 5v) (fn
WfrUC4fc 6,,,,,,? It 6. Qualifying Agent JOt VC' t
Address n City jQCX ►w)k. State AK Zip______522.6_
Office Phone "g� 0Z•67r7 Job Site Contact Num r '• 0 '.7
State Certification/Registration# (CC 133721? E-Mail (MVV EiA I • LL_C.Cry,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt tic 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,
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 0 I NER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT A OU • ''AYING TWICE FOR IMPROVEMENTS 0 YOUR PROPERTY. IF YOU INTEND
TOO:T, FIN , ' G, CONSULT WITH YOUR LENDE' • • A ATTORNEY BEFORE
REC••RDI+ '�-�•is" • TONI1CTIENCEMENT.
A ,/,
(Signature of Own-r, or Agent)
f
(Signature of Contractor)
i:ned an. :. to or affirme )be e m i day of Si ned and sworn to(or affirmed before.me this 3 day of
rpt (i ' Ak by l 2d 21,by °h6 V'e' ,,
,0- 1 _ /1 ,. ,//j:i AV
(Signature of Notary) (Signa ure of Notary)
VIr.M«rr<roa.w.•
i�
[ ]Personally Known OR � �' CHRISTIAN GILES[ ]p rs ally Known OR �pjr •., RIST1/1N
ti ..• =a� GILES
[ roduced Identification ;•. +� •:,, MY COMMISSION t5 HH 1[ rod ced Identification M
Type of Identification:F(� 01,_ -i; ,:-.11 EXPIRSS:Agit 13,20`4'ype of Identification: YCOMMISSION#HH 117153
•;ror.�• Booed ruu Nary V...:..1.,:Undermitu: } '•.E o,i�oe; Banff 13,2025