528 Aquatic Dr 2013 roof CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J =" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002389 Date 3/28/13
Property Address . . . . . . 528 AQUATIC DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4495
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Application desc
reroof
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Owner Contractor
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HASTY BELINDA ARMOR ROOFING CO
528 AQUATIC 3885 JULINGTON CREEK RD
ATLANTIC BEACH FL 322333838 JACKSONVILLE FL 32223
(904) 371-0234
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4495
Expiration Date . . 9/24/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: Permit Number:
Legal Description 3$-1 t S- al: -�&\Aem Parcel# rr a -5n
oor Area ot Sq.Ft. 1,q. t
Valuation of Work$ L yg�_Proposed Work heated/cooled_�; non-heated/cooled
Class of Work(circle one): New Addition Alteration Repa' Move Demolition pool/spa window/door
Use of existing/proposed structure(s)((circle one):. Commercial �. es
al
If an existing structure,is a fire sprinkler sys m installed?(Circle one No N/A
Florida Product Approval# 1 ' -� 1
For multiple products use pr uct approval form
Describe in detail the type of work to be performed:
Property Owner Information:
` \ �Y
Name: \1 Address: S,�L
City State ip 1 Phone - 1
E-Mail or Fax#(Optional)
Contractor Information:
Company Zn Quali ng Agent: ' -\A cA
Address: City_AX S to L- Zip
Office Phone - H Job Site/Con ct Number Fax#
State Certification/Registration# C C'
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. 1 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 laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a penod ofsix(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
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.
I hereb certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type q�work will be complied with whether speci N herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, oLlocal regulating construction or erformance of construction.
Signature of Owne. Signature of Contracto Q, .
QA�
Print Name l ' + 1.-......... PrintName -�.C"� ------...... AA
.................... ...........................
Sworn to and subscribed before me Sworn d sub d befl?In 20
this Day of ' th' Da of
• L KELLY, dl~ZZ,
No c EXPIRES MSY 3016 u .NF1 MIPSICN t< 57760
EXPIRES:Febru 2014
sipRF Cyd^ Bonded Thru Notary Public Underwriter evised 01.26.10