Permit Roof 1707 W Park Ter 2010 ' S 'f CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
� ATLANTIC BEACH, FL 32233
r f , INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001325
Property Address Date 11/02/10
1707 W PARK TER
Application type description ROOF PERMIT
Property Zoning
Application valuation . TO BE UPDATED
• 5000
Application desc
reroof
Owner
Contractor
MOURO
ARTISTIC ROOF SYSTEM, INC.
1707 PARK TERRACE WEST
2146 ACACIA RD
ATLANTIC BEACH
FL 32233 NEPTUNE BEACH
FL 32266
(904) 233 -8231
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee
Issue Date .00
Valuation . . . . 5000
Expiration Date
5/01/11
Other Fees STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2.00
2.00
Fee summary Charged Paid
Credited Due
Permit Fee Total 75.00 75.00
Plan Check Total .00 . .00
Other Fee Total .00 .00 .00
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
7 (
Job Address: ,a 7 P L �-
tl7 -IZo
A l e l &X,e i7 r e' I%v es 77 Permit Number:
Legal Description 39 — . 5 - 09 - 2-5- 29
oor rea o Parcel #
Valuation of Work 8_ 5Uo0 Proposed Work h /cooled l I o p t
n - heated /cooled X
Class of Work (circle one): New Addition Alteration Repair eve Demolition pool /s a window/
Use of existing/proposed structure(s) (circle one): mercial p window/door
If an existing structure, is a fire sprinkler system installed? (Circle one): • eS ' a °ti.
Florida Product Approval # 7 q. / N /A
For multiple products use proauct approva orm
Describe in detail the type of work to be performed: 2 7 f
Property Owner Information:
Name: � o ell al 0 42 s: /0
Address: /0 A. ! ee-FT
C ity /4A. /3 e w a State Zip Phone
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: r'1 i-;S'�'i c R s s AI j /dc Quali fying A ent:
Address: ' 7 P ( ��� uSn
� r�ac ,
Office Phone CZ 0 (1 _ y3� 7 ft�G ,Wob Site/ Contact City `��a S° f C ° State N'/ Zip s
State Certification/Registration # r\ C c_ !3.2 �'rS3b 1 I l y Fax # �) tS `� ^ � 3 =� �' L/3
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. / certify that no work or installation has commenced prior to the
issuance o/'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 f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for apperiod 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, Bo Heaters,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
/ hereby ert that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner r .-N 1�'» -t:- • /� �
Signature of Contractor
Print Name �� j MAro
Print Name .bk,6.a. k Jack56
Sworn i o and subsc i ed before e
Swore
A L's 1. y of " � ,- .„ b O �1, :/
I _.114.1 r... TIFFANY HELEN GA �, , J u ;i •,r r; 20 /0
/ ' r.. � • .. , ' Public - State of Florida di , ' y'' ° E ISSIc, r r g i 26 j
Notary Public ` My Caasw. , ry P �`` ., _EScMay
.c COnnlNatoa OD Aug 818 " ` ry Pu is
4\ 14' INN • NNlonai Notar Assn. 0
Revised 01.26.10