1085 Atlantic Blvd Bldg 9 2012 Roof CITY OF ATLANTIC BEACH
-^� J 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12- 0001023 Date 8/07/12
Property Address . . . . . . 1085 ATLANTIC BLVD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 20000
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Application desc
REROOF BLDG # 9
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Owner
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Owner Contractor
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ATLANTIC ARMS APTS LTD INTEX BUILDERS LLC
4000B ST. JOHNS AVE #22 P 0 BOX 272140
JACKSONVILLE FL 32205 TAMPA FL 33680
(813) 293-0732
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 150 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 20000
Expiration Date . . 2/03/13
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Other Fees . .
, STA E DCA SURCHARGE 2 . 25
STA E DBPR SURCHARGE 2 . 25
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Fee summary Charged Paid Credited ----Due---
----- ---------- --- ----
Permit Fee Total 150 . 00 150 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 50 4 . 50 . 00 . 00
Grand Total 154 . 50 154 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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BUILDING PERMIT APPLICATION
p CITY OF ATLANT C BEACH
/ 800 Seminole Road, AtlantiBeach, FL 32233,
I
office(904)247-5826 Fax(904) 247-5845 �!
Job Address: u1, tr 21 — UA Permit Number:
Legal DescriptionParcel#
Floor Area o q. t. Sq.F1
Valuation of Work S -Z u 00 2 Proposed Work heats /cooled 14D 0 non-heated/cooled
Class of Work(circle one): New Addition Alteration Rell air Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):. •ommer Residential 95)
If an existing strucure,is a fire sprinkler system insta ircl one): Yes No
Florida Product Approval #
For multiple products use product approve form
Describe in detail the type of work to be performed: 'e
All 1140
tiC S(1 Wr
Property Owner Information: A/21!,77
Name: Address: opo 3 31' Ot9 dtJJ , RlC .y
Cit), L State' Zip r Phore
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: fN Tex 1)r%,beg5 Qu lifying Agent: Ow rhkTi l
Address: P 0 6 ?--1 it%ka Ci TPCr_f?% State _Zip 37L-s
Office Phone 13-16,0- 90�0 Job Site/Contact Number 1?-2 I Fax#
State Certification/Registration# C_C_t (9 2`i
Architect Name&Phone#
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
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 a1 laws rregulating construction in thpis jurisdiction. This perat any mit becomes null
andwork isco wmenced.otI undeenced within six rstand that separate permits muor st be seccommured for Ele trical Work,Plumb ng,Sigion or work is suspended or ns,or aWells,Poolsx uTnaces,monthSBoile s,tlfleatme e►s,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAIL RE TO RECORD A NO'T'ICE OF
COMMENCEMENT MAY RESULT IN YOUR AYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU IN'T'END TO STAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEF RE RECORDING YOUR NOTICE OF
COMMENC MENT.
1 hereby certify that 1 have read and examined this application and know the same 19 be true and correct. All provisions of laws and ordinances governing this
hype of work will be complied with whether specified herein or not. The grants of a permit does not presume to give auth cviolate or cancel the
provisions of any other federal,state, or local law regulating construction or the pe formance of construction.
Signature of Owner Signature of Contract r �.I/
Qp /J Print Name
Print Narver !"L . Y1! .......
s................ �!...... ......................................... ................... . ............. ............
Sworn to and subscril e me Sworn to and subscri _hefoteine 20
/-2 this __
this a
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Nota
Notary ► _ o=C 1jjssloN#DD8� 3 � ���,1r. �N#DDit70390
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