Permit 1743 E Park Ter CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000052 Date 1/19/10
Property Address . . . . . . 1743 E PARK TER
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 22650
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Application desc
REROOF FL 6710 HVHZ
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Owner Contractor
------------------------ ------------------------
FULLER, ELZER ADVANCED METAL ROOFING, INC
1743 PARK TERRACE EAST 13827 NE 199TH STREET
ATLANTIC BEACH FL 32233 WALDO FL 32694
(352) 468-2064
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 163 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 22650
Expiration Date . . 7/18/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 163 . 00 163 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 163 . 00 163 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Y
09-
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date: il/d. jrj+'
Job Address: />,9i'L/< /,IAr7/C- x'/ 3-2233
Owner of Property: /�V7 e-
Address: �7�, ����� �'.�iC Telephone:
Roof Contractor: /y 0// Vy y',a /2d��„ug State License Number: c-c-
Contractor's Address: 7- ✓p/p 0 9E/
Telephone:_ �02-3)-L//(p (o Fax:_�'Sl� - 3)y-039-f Email:
Scope of Work:_ M M j A 01 e-> Roofing f.,aterial Me71Z.O R-esQ�;ror►
FL Product Approval# F I - (p� V (� Tp 1 )
Valuation of Work: `-
Required Inspections: Sheathing/In Progress-Dry In /Final
If re-roof: Assessed Value of Structure:_<$300,000/_>$300,000;Roof-to-wall improvements required?
(Applies to single family structures only)
"WARN!"IG TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENrEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE !013 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER:
• Date.
MY COMMISSION*O 1359
AS TO C` I FR: F-xPIRGS mpg.3,010
Sworn to _ i subscribed before me t is��,o00;;`�a,57
N ery 5eryic om
State of"' "a,County of Duval
Notary's Signature:
❑ Personally k wn
(produced identification ,/
Type of identification prr_',iced Kel-3 D[.4�- Fa/ -t.0S-- 7a-7
SIGNATI %F CONTRACTOR: Date:
AS TO Com. : RACTOR:
Sworn to acid subscribed before me this
---�-�---day of l ------
State of Florida,County of Duval
Notary's Signature: `1',
�Persorra y known
❑ Produced identification CRAWFORD
Type of identification p. * My COMMISSION NDO921773
I :September t;20M,
800 Seminole Road•Atlantic Beach,Florida 32233-5445 ��"'$OFF`°'�e BMW ThraBWWNo"
Serdces
Telephone: (904)247-5800•Fax:(904)247-55 15
F:\roof permit applicaton.docx 7/28/09
�tm-C-CF7b1 04:40 FROM:CLERK OF COURTS 904 270 1512
000 0 2010011671, OR BF; 15129 Page Boa, Number Pa 70:92475845 P:1�1
at 10:41 AN, JIM FULLER CLERK CIRCUIT 004RT DUVAL OU 1' 01WING $ 01/19/2010
COmI7RTY RSCORtDING $10.00
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