Permit Roof partial 540 Sailfish 2010 !,%l.t`1;r
�'
AIL
` j CITY OF ATLANTIC BEACH
;4 �, r) 800 SEMINOLE ROAD
J . ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
" .0131
Application Number 10- 00001340 Date 11/04/10
Property Address 540 E SAILFISH DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 1900
Application desc
Roof Repair
Owner Contractor
BAC HOMES LOANS (BANK) SCHULTZ ROOFING, INC.
540 SAILFISH DRIVE 216 N. 20TH STREET
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246 -2315
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/03/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 60.00 60.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 64.00 64.00 .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
Job Address: c 9, ') C, t i /-,eS /, Permit Number:
Leal Description r �z/ S ( 4/ (//y)- //� Parcel # /7,a9/
- 2�
g p M oo r A rea o S .rt
Valuation of Work $ /9O0 Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition Alteration Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial .
If an existing structure, is a fire > sprinkler system installed? (Circle one �'^� No N /A
Florida Product Approval #3 Ko FL 115. 3
,> Florida
multiple products use product approval Corm
Describe in detail the type of work to be performed: oge / 0/4 C /96 4rp6fic.,/i A t ' Kom" tt tr i s ti ie
Rix* R
c .- y
Property Owner Information:
Name: 9��e t`.nR -U /t9� Addr %/ 9 �� ! �p .
City _Ad' State Zip 7 Phone , '
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: Schultz Roofing Co., Inc. Qualifying Agent: Douglas A. Schultz
Address: 216 N 20 St City Jacksonville Beach, Fl. 32250
Office Phone 904 - 246 -2315 Job Site/ Contact Number 759 -0063 Fax # 904 - 247 -3808
State Certification/Registration # CCCO36989
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. 1 certifr 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 a period of six 16) months at any time after
work is commenced. 1 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.
1 hereby cert that 1 have read and examined this application 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 speci red 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 regul construction or the performance of construction.
Signature of Owner .47'�� 4 Si natur
11 g e of Contractor
Print Name 4 Alp( (.,3 TD WA I Aor, 5 kT Print Name Douglas A. 'resident
Sworn to and subscri d beforen,e Sworn + and subs e,,d, before me
this <7 Day of ) , 20/ 9 this i Day of 'I J h . , 20 /e
Notary Public ROSAUNDCLARK Ot
MY COMMISSION # EE 001736 g "•
t 11 =
'` RosAUNDCLARK
S EXPIRES: August 25, 2014 ? +: !� .rz MY COMMISSION R EE 001 ev d 01.26.10
Nap Bonded Thru Notary Public Undernrners 4ti EXPIRES: August 25, 2014
, eF tt '' Bonded This Notary Public U ndMwrikn