Permit Roof 2010 -'Z�
7�1" T,1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001113 Date 9/08/10
Property Address . . . . . . 890 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2400
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Application desc
reroof
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Owner Contractor
------------------------ ------------------------
FERNANDEZ SHORE ROOFING COMPANY
890 BEACH AVENUE 914 7TH AVENUE SOUTH
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 241-8842
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Permit . . . . . . ROOF PERMIT
Additional desc . -
Permit Fee . . . . 65 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 2400
Expiration Date . - 3/07/11 ---------------------
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Fee summary Charged Paid Credited --- Due---
----------------- ---------- ---------- ---------- ---
permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 65 . 00 65 . 00 . 00 . 00
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09-
CITY OF ATLANTIC BEACH
Date: ROOFING PERMIT APPLICATION
Job Address: 131�f() 6n� /'+V<-
Owner of Property:
Address: Telephone: S, /0
State Ucense Number: CIC C 6
RoofContractor: 9�orc, t�0C4"',-( CL,
Z
Contractor's Address: 'I ,
g/11 SOCA 37k7c Al,,-� F
Telephone: iv ?- Fax: 1-1903 Email:
Scope of Work: /Pov F av c V- Fl,*�-1 Iq I—Ao-o--"N�49Material
Fl.Product Approval# valuation of Work: S
Required Inspections: Sheathing/In Progress-Dry In /Final
if re-roof.- Assessed Value of Structure:Z14$3W,000/__>$3WOW;Roof-to-,wall Improvements required?
(Applies to single family structures only)
'vWARNING TO OWNER: YOUR FAILYRE TO RECOR NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YO PROPERTK NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE FIR NSPECTIO . IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN A R RDIN U NOTICE OF CO ENCEMENT"
SIGNATURE OF OWNER:
DEBORAH A.WHfrE'-'
My COMMISSION#DO 6-341.
EXPIRES:May 21
AS TO OWNER: SOnd'd F�m Notaty Pubr.(
Sworn to and subscribed before me this day of .20/
State of Florida,County of Duval
Notary's Signature:
[] Perso6lly known
.-;�Produced identification
-Type of Identification produced
DEBORAH A WHI-rE
R: Date: My COM ISSION#DD 63
SIGNATURE OF CONTRACTO i
EXPI ES:May 21 2011 .6
AS TO CONTRACTOR- Son ry A�b*c�;Cdlor.6,.r.s
Sworn to and subscribed before me this day of C 20//0
State of Florida,County of Duval
Notary's Sign at
ersonally known
0 Produced identification
Type of identification produced
800 Seminole Road-Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800.Fax:(904)247-5845
F-Nroof permit applicaton.docx 7/28/09