Permit 971 Amberjack laner
CITY OF ATLANTIC BEACH
800 SENIINOLE ROAD
ATLANTIC BEACI~i, FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-deptfa?coab.u5
Application Number 07-00001399 Date 10/09/07
Property Address . 971 AMBERJACK LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . 5900
Application desc
REROOF
Owner Contractor
LUNDGREN SUNLIGHT SOLUTIONS, INC
971 AMBERJACK LANE 4 SEATROUT ST
ATLANTIC BEACH FL 32233 PONTE VEDRA BCH FL 32082
(904) 543-1300
-----------------------
Permit ---------------
ROOF PERMIT ------------------------ --------------
Additional desc .
Permit Fee 60.00 Plan Check Fee .00
Issue Date Valuation 5900
Expiration Date 4/06/08
Fee summary
----------------- Charged
---------- -- Paid Credited
-------- ---------- -- Due
--------
Permit Fee Total 60.00 6D.00 .00 .DO
Plan Check Total .OD .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.
. ~
k.,
s ~`;~,~ CITY OF ATLANTIC BEACH
...
•
07_ ~_~ ~ ~
=~ ~'~ 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233
r f `'}+ ! OFFICE: (904)247-5826 ~ FAX NO.:(904)247-5845
fa.'. BUILDING-DEPT@COAB.US
'=-'~~ BUILDING PERMIT APPLICATION DUVAL COUNTY
1. JOB ADDRESS: ' 2. VALUATION OF WORK: 3. SO. FT. UNDER ROOF
~~ ~ ~ ~~~ ~ s~s~
4. LEGAL DESCRIPTION: 5. CLA S OF WORK: 6. USE OF STRUCTURE:
^ NEW BUILDING ^ DEMOLITION ^ RESIDENTIAL
SUB DIV
BLOCK
LOT ISION ^ ADDITION ^ CONVERTING USE ^ COMMERCIAL
_
_
DESCRIPTION OF WORK:
7 ^ ALTERATION ^ ACCESSORY BLDG. 8. FIRE SPRINKLER:
. $rREPAIR ^ POOL /SPA ^ YES ^ NIA
^ MOVE ^ OTHER ^ NO
.,~ noorv n ~u.rco. r•.nuTR ecTnlz~ ARCHITECT /ENGINEER:
9. NAME: // ,, 15. PANY NA 23. COMPANY NAME:
yJ ~ C ~J~le~~/~//J~~~ i,~ ~~ ~ ~~f..~,,
~/ J/ L ((~J 1 AME: 24. LICENSEE NAME:
10. ADDRESS: ~ ~ /
w _
17.
NO.: 125. STATE OF FLORIDA
18. ADDRESS:~~~ ~_ . rv.,~ 3,$ ~~'~ `~ ~ 26. ADDRESS:
7" ~ ~£c
y. f.. ~~,~~ fj'i:
I/v v r
1 ]„ONCE E~0 ~ 12. FAX NO.:
19 OFFICE PHONE:
20. FAX NO.: (,
27. OFFICE PHONE: 28. FAX NO.:
CALL PHON ~ `
l / 21. CELL PHONE:,
~'I ~i X~~,S"`~ 29. CELL PHONE:
1 MAIL ADDRES
L% L 22. EMAIL ADDRESS: 30. EMAIL ADDRESS:
FEE SIMPLE TITLE H LD R:
pFOTHERTHANOWNER) BONDING COMPANY: MORTGAGE LENDER:
31. NAME: 33. NAME: 35. NAME:
32. ADDRESS: 34. ADDRESS: 36. ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a 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, Air Conditioners, etc.
OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law.
~~ WARNING TO OWNER: ~
YOUR FAILURE TO RECORD A 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 AT ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OW R or AGENT CONTRACTOR
(ItA~ant. werof. OrneyorP.gencyLeCerRe~uired) (Qualifier Only)
Signe Date: ~ ~ ' ~~
Before me this ~_ day of , 2007 in the county of
Duval, State of Florida, has perso Ily appeared
Efzi t< I ~-~- Lttiy~4 r~
herin by himself /herself and affirms that all st ements and declarations are
true and accurate. ~~ , , A/
+N~,oJtary Public at Large, State of , County of ~W`r ~'
.personally Known
b Produced Identificatio
Notary Signature:
~J. ~~~t~
COAB FOKM BLDG01: REVISED: 8!212007
Signed: / //.I~~--~ L./ ~./~/ Date: ~ ~/ J~~
Before me this ~ day of 1)C1~~~- , 2007 in the county of
Duval, State of Florida, has personally appeared
~~/ f<C- ~. ~i L ~ -
herin by himself /herself and affirms that all statements and declarations are
true and accurate.
Notary Public at Large, State of ~N ,County of ~w~a-I
^PersonallyKnown ~/~/~ ~ e r
Produced Identification ~~ 1~ ~t.tiC) ~ ~y~J ('
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