79 Shell St re-roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
_ INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
706 INFORMATION:
Job ID: 16-ROOF-2719
Job Type: ROOF PERMIT
Description: re-roof FL 10124-R19
Estimated Value: $9,400.00
Issue Date: 12/6/2016
Expiration Date: 6/4/2017
PROPERTY ADDRESS:
Address: 79 SHELL ST
RE Number: 169583-0000
PROPERTY OWNER:
Name: BOLE, BRUCE S
Address: 79 SHELL ST
GENERAL CONTRACTOR INFORMATION:
Name: ROOFING LABOR INC
,CCC 1330801
Address: 112 BEROT CIR ST JOHNS, FL 33259
Phone: 904-437-7530
FEES:
BUILDING PERMIT FEE $97.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $101.00
PERE IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
c L Office(904) 247-5826 Fax (904)247-5845
.:ori .?.A@drrx: 1q She11 �1�r.�.Q�t A'�fih}IG gC��f 32233 Permit Number:
LOT BV
L•-gizl Des.:ription 15-R7_. m� _mv . pi{a10 LSIDITt ate Parcel#
E oor a of�q�'f. -
VLduisdom of World$q, H Proposed Work heated/cooled 2543 non-bested/cooled _
. ,_s�b+1Wor._(ciwJe one): ex Addition Alteration Repair Move Demolition pool/spa window/dour
useorexisting/pro osed structure(s)((circle one): Commercial Residential
If an existing structure,is a fire spnnWer system imtaifed?(Circle one)�o
Florida Product Approval#duo I2yr
For multiple products use product approve orm f� /r` y
Describe in detail the type of work to be performed: RM t rep IQ(,e Y112YI 1
,e;caiv Owner Information:
ill: Address:- P.It S�
hRmaicI3P �S to Zip 2 Phone
r. or �Z'x k ;O nional 4L 7 �JJ mulst . OU
Contractor Information: II II
Company am':E b Quali in Agent: 1� N Xtl
Address: ( T City� State Zr
Office Phone - - J b�Siti(Cjntact Number -t -l Fax# 1 - 5
State Certification/Regi
33 ll� 11
Architect Name& Phone#
'..npinaei s Name, & Phone
-Fx Simple 1'aie Holder Name and Address _-_.-__--
Sending Company Name and Address
.'ooiq,age Lender Nnme and Address ._ _-_--.--
dpplicalian is hereby rrarde to obtain a permit io do the work and immllanom as indicated. I certify that no work or installation has commeneedprior to
issuance ).Permit and that all work will be poya med to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes
and void J work is not eammermed within six(6)months, or if construction or work u suspended or abandoned far a period of rix/6)months�ol/e any
Hear
work is eumnaaurJ l understand that separate permits most be secured far&ecrrirnl Work, Plumbing,Signs, Wells, pools, fu maces,
Tanks and Air Conditianr+s,me.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTc
3 YOUR PI?OPERTY. IF YOU INTEND TO OBTAIN FINANCINGCONSULT WITH
V&lUR LENDER OR, AN A'T'TORNEY BEFORE RECORDING YOtUR NOTICE OF
COMMENCEMENT.
Ii r h tv.had o,d e.Ay ined don-uetplicaaun ail ae is be irue and ca+rect Ill pr r m . .. ! /`^•
A - I ! .d d th 10,011,11 spery s he+em or F'°.. t g +f a permit does not t s r "1, r I .. r
(nw+egnlur+ng rnn. _ pe+pm+++u eo/conetru<aon s.
,R
signature of Contractor
Signature of Owner >, Si Bn n D
n��p �rt �c< r exLnn s <
Print Name .1 tak iL_W.� _. nam Print Name ._ypr.��p4m1',} .. _.. �SA.!ua.. .... --
Sworn to and subscri a before me =3 "- Sworn to and subscri before e ;
his -c Day of this L Day -✓ n
-
oo.W y No he o..u•e1 a. '� � ao m�
N tD n Revise)01. .I® ,,Z
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Doc A 2016265522, OR BE 17782 Page 984, Number Pages: 1, Recorded 11/18/2016
at 12:23 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
PNEOnRE x WNIGIE
Pertrvl No Tax Fon.No
SMted FAim Doom,of D..us
Towhom n may concern:
Th.pnUarallfhad hereby Informs yep that Impfovam°Ma wlll ba hada to OWUNA teal property,and m
acoamance Mtn Section Tia Of the Fbtlda 8tamtes.the 1o0 h jmN WrOmnatlon 11.bled In mle NOTICE OF
COMMENCEMENT.
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