Permit 354 11th Streetd
CITY OF ATLANTIC BEACH
800 SEP~IINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 07-00000141 Date 2/14/07
Property Address 354 11TH ST
Application type description ROOF
Property Zoning TO BE UPDATED
Application valuation 2410
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Application desc
re-roof/ 30 yr archect/shinlge
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Owner
------------------------
TRUSSELL, GALEN
354 11TH STREET
ATLANTIC BEACH FL 32233
Contractor
------------------------
DIBBLE ROOFING COMPANY
3525 MORTON STREET
JACKSONVILLE FL 32217
(904) 731-2835
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Permit ROOF PERMIT
Additional desc .
Permit Fee 47.50 Plan Check Fee .00
Issue Date Valuation 2410
Expiration Date 8/13/07
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total
Plan Check Total
Grand Total
47.50 47.50 .00 .00
.00 .00 .00 .00
47.50 47.50 .00 .00
PERNIIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLAN'T'IC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
>""
.t ~' BUILDING PERMIT APPLICATION
.~ti.;~ ..., _, - CITY OF ATLANTIC BEACH
~ rtivyj 800 Seminole Road, Atlantic Beach FL 32233
Office: (90447-5826 • Fax: (904) 247-5845
lob Address: /~o ~ as'~ 9 ~ 33''j' !/ •~~~ ~/ ~c~_ .Permit Number
Legal Dtseription/6 .25=~ 9,E ~fC+i.+.>l~G BeACG Lefo2,r`8l•E. /,~ - lyf(aN• G %e l~~C 7/7.3 o17r
Vainatian of Wor[c (Replacement Cost) S oZ y/D, ry
• Class of Work (Circle one): New Addition A.iteration e
^ Use of existing/propasnd stnicture(~s) C~irde oae): Commerc•
^ Ids ~ f bom~wnd assoeiation or ~ ~~led? (Cir'de oae): Yes N fA
^ approv private eahty required? (Cucle oae • Yes ~
i Describe irr dleta~ the type of work to be performed: .Qe,Q, o~ ,Py -~ %~ ~3o FP /
NEE b fQa~E fi. P<oA.~T A/~sirral ~ 2P %~ ~ ~ 3o r~ ~%JPr ~,~r~/
D......e..s., e1e.......7..s ~_u.._. ff/pP'L°'''~' G /y7 s/•.ak,~ 1J
City AfCw~ f~c RPAc~
Contractor Information:
?dame of Comvanv: D i b
~~ Qualifying Agent: ~o ~ .~• (.7 : 6 6 /e
City .7~-b State ~G_ Zip ,~»/'7
lob Site/Contact Number
c'~/6 l Office Fax # 90 !Y 7 ~~
Office Phone _7 P~..~-83~
State Certification/Registration # G fC
Architect Name & Phone # ~
Engineer's Name Bt Phone #- _____~~~
is hereby mode to obeain a to do the nonE and inrtoi/atlons as tndieaKd I aertt, jy t/r~ no work ar iiWdtation Ims eowrmencuf pior to tMe
~p~atitandthotollnorkw fi7 be~erformsdtomattheseaxdari daUla~wregu cronakvctioeintlus~urird&tiore 7lrispsnreitbscosrtn~rfland
n trot commabed within sis (6} woruht~ ar ijconsrrrctiart or varkis suspended orwdoned jora~~rrrr ofsa (ti) a~oatht at etrytinee hark it
Iw~derattuedshotseparstepsrmitsnarslbeaecunsdjorEle~iml Ww1r.lAatrtbiwg,Sfi~er,Wdir,Posit,Fxntaoes,Bo!/os.gearets,T~aua1.lir
s, eta
WARNIlVG TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Il~veyyyy thatf hate read and «amined fhb aipjplieatian and know the.x+mt to l e nve and carraet AUprovision: ojlavs and ordl+nnces diia
ojworkrvill complladwlth~rAetherspee~dhsrsrna•n~ ThsgraruirtPaja doea+eotpnsamstoglweantharitytoridateorcamxl~aro~
other~6derinl, state, or local law tegulattgg caudvctfas ar the perJitrmmrce construction.
Signature of Property Owner. /
Signature of Contractor: ~ ~~,ti~G~
Sworn to and subscribed before me Sworn to and subscn ed before me
this ~ Day of ~+c h. 2m-~ this ~ Day of
NoMry Pub1c - Sllb d FbdQr
' g~MAI~ T. 2001
Coa~~i0D1lIiN
DO NOT
Review Result (Circle oneZ
Approved Disapproved Approved w/ Conditions
NoYuy P'uOMC • 8WR d Fbdd~
Comn~lon t= 1M~ 2, 2009
ComaM~NoatCND~t1i11
Review Initials/Date:
Development Size
Habitable Space Non-Habitable Impervious area Total Area
lvfi~ llanecoyu In~formati~on
Tvae of Conslxu~ coon
Number of Stories
Zoning District
# Parking Spaces
Iv1ax.Occu an a
Fire Sprinklers Require~~
Flood Zone
L,:onditionslCommeats:
xe~;na tvutoe
L'd CbfiO-/b7.-MYi
swets~(c uoneuuotui
ern: ~_ t ~n ~ i sea