725 AMBERJACK LN - ROOF tr-
CITY OF ATLANTIC BEACH
J�;,:•,,, .:_> ,_: ,, ,) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
A .21
INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2481
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $7.600.00
Issue Date: 10/19/2015
Expiration Date: 4/16/2016
PROPERTY ADDRESS:
Address: 725 AMBERJACK LN
RE Number: 171195-0000
PROPERTY OWNER:
Name: CASTNER, JENNA
Address: 725 AMBERJACK LANCE
GENERAL CONTRACTOR INFORMATION:
Name: LOCKE ROOFING LLC
Address: 24 E 4Th ST
Phone: 904-424-7618
FEES:
BUILDING PERMIT FEE $88.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $92.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: 7 2 5 A vvl V J(,-(-k LIA-v• Permit Number:
Legal Description Parcel#
Valuation of Work$ i 600.0v Proposed Work he ted/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):installed?Commercial Residential
If an existing structure,is a fire s rinkler syst m installed?( ircle one): Yes No N/A
Florida Product Approval#FL. ((,30,5-1�3 A., kb pr;5�
For multiple products use product approval form `�C 5�� � e S
Describe in detail the type of work to be performed: Km-fs u." rr/c e„
Property Owner Information:
Name: 1i vwy. H au..l� Address: "l 1( 14 r►A
City c.)6 �4.4s State Fc.Zip 322Sa Phone t.o 3- a ZZZ
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company N.rue: L 0 G K.e- Pt aiJ ` , I—1— �, Qualif�'ng Agent:
Address: CJ eMOMM��. �� _; Ci U Gtado/urdie, State FL Zip 3 2.',02
Office Phone � 5 5 ' Job Site/ ont ct NumberU41■Cl a' -ti #
State Certification/Registration# 133 Q
Architect Name&Phone# /VA
Engineer's Name&Phone# /1/'A1
Fee Simple Title Holder Name and Address /l/.j
Bonding Company Name and Address NA
Mortgage Lender Name and Address /V/#\--
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certi'that no work or installation has commenced prior to the
issuance?fa 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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(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 Np F ICE 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 NOTI 's
COMMENCEMENT.
l hereby cert that I have read and examined this application and • , i s• '-o be true and correct. All provisions of laws and ordina ego°' ni this
.yp e of work will be complied with whether specified herein or no t - : ,g of a permit does not presume to give authority t
,rovisions of any other federal,state, or local law regulating coast ilo,* 't'. •-rformance of construction. �' °vt' • or - the
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signature of Owner J )" `C' m �,Z ! E
--- o Signature of Contractor
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otary 'ublic '�' — Notary Public �� 'Ili
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6g - i — Revised 01.26.10
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