Permit Folder 79 W 8th St CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J y ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000207 Date 2/25/10
Property Address . . . . . . 79 W 8TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2480
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Application desc
REROOF
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Owner Contractor
------------------------ ------------------------
KRAUT RON RUSSELL ROOFING INC
79 WEST 8TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 636-9909
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1420
Expiration Date . . 8/24/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 60 . 00 60 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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10-
CITY OF ATLANTIC BEACH
Date:
ROOFING PERMIT APPLICATION
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Job Address: ? L $7�1 t ARA 04't Rl9' H F C 32Z 3 -
Owner of Property: �e�(_� �- fAO T
Address: 79t 9 0 %N S f i R-,58 .,FL,3223 3 Telephone: _3 33'&4,07
Roof Contractor: - *(LR00F11)(4Vf.0 State License Number: CC( 1.7049'
Contractor's Address-. {-I Ou.AU_ Vb, C9�o1J�1�[
Telephone 7)1- Fax: b3 b-?U? Email:
Scope of Work: hh F (jy twsTo*- f#k&t0 Roofing Material //)LzFO ,�
����11�� l�/\`ri4 T
FL Product Approval# T L s444(7 Valuation of Work: $ Z/8
Required Inspections: Sheathing/In Progress-Dry In /Final
If re-roof: Assessed Value of Structure:_<$300,000/_>$300,000;Roof-to-wall improvements required?
(Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNE EFORE RECORD
ING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER: "' Date: -;2- b
AS TO OWNER:
Sworn to and subscribed before me this day of i IS c u A(i- 20 16
St
L14KI).3-NOTARY
SUSAN SPEAKS GORMAN Notary's Signature:
MY COMMISSION t#DD643668EXPIRES:February 25,2011 Personally known
FL NotaryDiscauntAssac.Co. Produced identification
Ty p I tificationproduced ELG\2o 'LSo(,;,3 3330
SIGNATURE OF CONTRACTOR: Date: Z — Z ' —C Q
AS TO CONTRACTOR:
„"", DEBORAH A 01TE
r '••
Sworn to and subscribed before me this Z day of -Zv. .20/0 � � My COMMISSION#DD 634126
EXPIRES:May 2011
State of Florida,County of Duval IladeanwrlrnanPublic xcunaennuara
Notary's Signature:
Ll Personally known
Produced identification r--rn R2—K07 2 3 /
Type of identification produced �I Lam- ��7 G �.Z v
800 Seminole Road•Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800•Fax:(904)247-5845
F:\roof permit applicaton 2010
JAN-4-2000 16:00 FROM: TO:92475845 x:111
Page l of 1
* 1578959*
• '• Print pate:
Transaction#: 1578959 �MT ^ 2/25/2010 1:51:42 PM
Receipt#: 1523637
Cashier Date: 225/2010 Jinn Fuller
1:51:35 PM Clerk Circuit Court
(KPEARSON) Duval County
330 E. Bay Street Rm 103
Jacksonville. FL 32202
(904)630-2044
Customer Wtgm cation Transaction Information Payment Summary
DateReceived. 02/25/2010
Source Code: BEACH
()RON RUSSELL ROOFING INC Q Code: BEACH
Return Code: Over the Total Fees $10.00
Counter Total Payments $10.00
Trans Type: Recording
Agent Ref
Num:
1 )Payments
MCASH $10.00
1 Recorded Items
ffrak BKPG: 15165/1800 CFN:2010044060 Date.-212512010
04s)NOTICE 1:51:34 PM
COMM.L'•_NCEMENT From: KRAUT OLIVER To: COMMEMEMENT
INDEXING 2 $0.00
RECORDING 1 $10.00
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