Roof Permit 128 Ocean BlvdCITY OF ATLANTIC BEACH
800 SENIINOLE ROAD
j ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
t onIS);a
Application Number . . . . . 03-00026139 Date 5/27/03
Property Address . . . . . . 128 OCEAN BLVD
Tenant nbr, name . . . . . . REPLACE, 25YR, 3-TAB,GAFROY
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
Owner Contractor
WADDINS, GARRETT SCHULTZ ROOFING
128 OCEAN BLVD.216 N. 20TH STREET
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
904) 249-8146 904) 246-2315
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 4000
Fee summary Charged Paid Credited Due
Permit Fee Total 75 . 00 75 . 00 00 00
Plan Check Total 00 00 00 00
Grand Total 75 . 00 75 . 00 00 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH PERMIT ..CALCULATION SHEET
Address—as 0 Cc"_v'j
Date
Heated Square Footage mer sq ft ..= $
Garage/Shed zser .sq ft = $
Carport/Parch @ Per sq ft .= $
Deck @ $ ver sq ft = $
Patio @ $ per sq ft = $
TOTAL VALUATION: S
35
Total Valuation 1st $ eo
i 5
Remaining Value 6-.00 per thousand
or portion thereof
TOTAL BUILDING FEE
1/2 Filing Fee P,5
F.irepla.ces @ . $15. 00. $.
BUILDING PERMIT FEE T-
WATER IMPACT FEE
SEWER IMPACT FEE
WATER METER/TAP
CAPITAL .IMPROVEMENT.
SEWER TAP
RADON (HRS) .0050: $
SECTION H PAVING (
HYDRAULIC SHARES
CROSS CONNECTION.
SURCHARGE .0050 $
OTHER
GRAND .TOTAL DUE b
ADDITIONAL PERMITS OR FEES : ,Mechanical Plumbing
Electric/New Electric/Temp SwimmingPool
Septic Tank Well Sign Finish Floor Elevati.on
Survey Other
CALCULATIONS and/or NOTES :
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
Y TELEPHONE:(904)247-5800
FAX:(904)247-5805
SUNCOM:852-5800
http://ci.atlantic-beach.fl.us
c f3 j PIAN REVIEW COMMENTS
Permit Application
Applicant: Q k L I f x ke) S'
Address: 2.;? 00(-cc el 1-2'1 f
Project: re ribo +
m/ Your application is approved
o Your permit application has been reviewed and the following items need
attention:
Please re-submit your application when these items have been completed.
Reviewed by
Signed Date
Contractor Notified Date
Mar 27 02 05: 53p Lt P- 2
J t
Citv of Atlantic Beach • 800 Se -unole Road • Atlantic Beach, Florida 32233-5445
Phone: (904)247-5800 • FAX (904) 247-5805 • http:i;wwwlci.atlantic-beach.fl.us
PERMIT APPLICATION FOR ROOFING
JOB LOCATION 128 Ocean Boulevard
O'W'NP:RO1 PROPERI'
YGarrett D & Celeste Wadkin ON'E4 249-8146
CONTRACTOR Douglas A. Schultz Schultz Roofing co . , Inc .
CONTRACTOR ADDRESS
216 N 20th Street
Jacksonville Beach , F1 . ZIP 32250
CONTRACTORS LICENSE NO.
CCCO36989
PHONE
904-246-2315
SCOPE OF YORK
DECK SLOPE^ CREATER THAN 2 : 12 ____-_ LESS THAN 2 : 12 ACTUAL
VALUATION OF WORK S 4,000.00
MATERIAL TO BE USED_g,N R,v;rt; S6V er e_ q_q ! ASTM DESIGNATION 31,I
REQUIRED INSPECTIONS _ SHEATHING FINAL
LIBILITY INSURANCE POLICY SUPPLIED YES NO
WORKERS COMP. POLICE' SUPPLIED YES NO
CONTRACTOR LICENSE SUPPLIED YES NO
OCCUPATIONAL LICENSE,SUPPLIED YES NO
r'Y
SIGNATURE OF OW"TER X't' '1-
SIGNATUREOF CONTRACT, R
S
ROSALIND CLARKDCLARK •`
E ME THIS DAY OF 2003
iin'n"'•
MY COMMISSION#DO 137721
EXPIRES:August 25,2006
A ThruN mryPobAoundenw m NOTARY PUBLIC
AS TO CONTRACTOR NOTARY PUBLI
ROSALIND CLARK
MY COMMISSION#DD 137721
i EXPIRES:August 25,2006
Banded Thni Pbmry PubBc Underwriters