92 13th Street West Permit Roof 2010 `SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
+} ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
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Application Number . . . . . 10-00001210 Date 10/04/10
Property Address . . . . . . 92 W 13TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4750
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Application desc
reroof
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Owner Contractor
------------------------ ------------------------
EVANS SHORE ROOFING COMPANY
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 . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4750
Expiration Date . . 4/02/11
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 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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09—
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Job Address:
91;L i A S7
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Address: AA/AFV -, ���f► ' c .y 1r�( � ��.,k:J Telephone: 9/3 '/ZG�1.�
Roof Com: SA o rt State Ucense Number: C C e- Or-Y-511
CoMuacboes Address:
Telephone: " Sf`d ti 2 Faz N 1 _ 'iYl Emaik
scope of work: 2 t 2 u I= Roofing Material 30Ze h• %*9 P?`o
Ft Product Approval# /q S valuation of work S
Required inspections: Slxm"g/in Rogress-DrY In /Final
If ne-roof: Assawed Value of structure:✓<$300,=/>$3W,0:Roof4oali►all improvemerts tegrdreR
(AppNes to single famRy seructures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR UNPROVEJNENTS Tn R PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORD®AND POSTED
ON THE JOB SITE BEFORE THE INSPECTION. W YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER ORANATTORNEY CORDING Y CEOFCOMMENCOWENT-
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SIGNATURE OF OWNER:
\\µY P 4
JASON DRACH
AS TO OWNER: ,F� = NotaryPublic .State of orida
Sworn to and subscrlbed before me this day,of20 • •-
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; oma; y Comm. Expires Aug 912014
State of Florida CDUrTLY of ) '�:,�� ;° Commission #EE 14 3
Notatys Signature:
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-----SIGNATURE-OE.CONTRACTOR:-- - Date:
AS TO CONTRACTOR:
Sworn to and subscribed before me this 4�dWof v� .20 l� .
State of Florida,County of Duval
Notary's
s 10 DD 9571
ary 14,2014
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DOC#2010230616,OR 13K 15385 Page 1089, Y
Number Pages:1 �,, JASON DRACH,
Recorded 10/04(2010 at 11:07 AM, ``" a '-
JIM FULLER CLERK CIRCUIT COURT DUVAL z Notary`Public State of Florida
COUNTY My Comm Expires Aug 9.2014
RECORDING$10:00 •';;r���o���� Commission 8 EE 14543