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Permit Roof 982 Ocean Blvd 2010 el t,L 'fr, i ; ' ... ' - � CITY OF ATLANTIC BEACH � ;�, 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 .\\ AVE ) INSPECTION PHONE LINE 247 -5826 Application Number Property Address 10- 00001344 Date 11/04/10 982 OCEAN BLVD Application type description ROOF PERMIT Property Zoning Application valuation . TO BE UPDATED • 1850 Application desc REROOF Owner Contractor ROULEAU MONAHAN ROOFING 2050 KING CR S ATLANTIC BEACH FL 32233 NEPTUNE BEACH (904) 568 -4920 FL 32266 Permit ROOF PERMIT Additional desc . Permit Fee _ Issue Date 60.00 Plan Check Fee .00 Expiration Date Valuation • 5/03/11 1850 Other Fees STATE DCA SURCHARGE STATE DBPR SURCHARGE 2.00 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 60.00 Plan Check Total 60.00 .00 .00 Other Fee Total .00 .00 .00 Other Fee 4.00 4.00 .00 64.00 .00 .00 64.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 5 '` 7 CITY OF ATLANTIC BEACH } 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 07- l� '}I OFFICE: (904)247 -5826 • FAX NO.: t 904)247 -5845 ‘ BUILDING - DEPT @COAB US 'r BUILDING PERMIT APPLICATION DUVAL COUNTY 1. JOB ADDRESS: 2. VALUATION OF WORK: 6 1 10 i 3. SO: FT. UNDER ROOF 4. LEGAL DESCRIPTION; 5. CLASS OF WORK: LOT BLOCK SUB DIVISION ❑NEW BUILDING 6• USE pF STRUCTURE: ❑ DEMOLITION ❑ RESIDENTIAL 7. DESCRIPTION OF WORK: ❑ ADDITION ❑ CONVERTING USE COMMERCIAL 0 ALTERATION { ❑ ACCESSORY BLDG. EPAIR ❑ POOL / SPA - PROPERTY OWNER: ❑ MOVE ❑ OTHER 0 YES ❑ N/A 9.. �N�A,^.M�E•: CONTRACTOR: ❑ No 1" n t p_Oct k eLi 15. COMPANY NAME: m 6 r. In 23• CO MPANY NAME: 4 Gv. �C:t� C �.o 10. ADDRESS: • I, I 0 .../.1. 17. STATE OF FLORIDA LICENSE NO.: C I 2 VZ (� `�"� I , C Oo Li ., 1 3 (, 25. STATE OF FLORIDA LICENSE NO.: 18. ADDRESS: 2 S 26. fr.:. " C. ,� \ �r .' r �( 26. ADDRESS: - r,_ 1 L OFFICE PHONE: 12. FAX NO.: f Y-'7 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.: 13. CELL PHONE: / 2z _Gus 22 �� t d G `' 21. CELL PHONE: — 7 - 6 �i /' 2 C.> 29. CELL PHONE: 14. EMAIL ADDRESS: h " Z 1 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: F EE S IMPI,E , TITLE HO L D ER : l L "1 o nc.L,1 ~ t C ^1 � t (IF PL.ETHANowNER) BONDING COMPANY:: ' MORTGAGE LENDER: 32. ADDRESS: • 34. ADDRESS: 36. ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or i nstallation 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 for a period 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, Boilers, Heaters, Tanks, Air Conditioners, etc. OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. pp ble YOUR FAILURE TO RECORD A NOTIARNING TO OWNER: ***- PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY NOTICE O FT IN YOUR F COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT THE LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT R OWNER o fi ENT . (If Agent, - o', -r of Attorn. gent CQNTRA( 1 ) I _ y,ette Required) Signed: ir 6 ,i/ (j i �� / � ne ��1 (Qualifier Only) • 4:e =te: .. / Sig ��� ��� �� Before me this 2 y _ V _ .�_ d of fr_S ✓ , 2007 in the county of Date: Duval, State of Florida, has personally appeared Duval, State of Florida, has personally Befr re me this day of `t. d a 2007 in the county of ppeared herin by himself / herself and affirms that all statements and e - clarations are herin by himself / herself and affirms that all statements and declarations are true and apcurate. Nota P merge, State of of true and accurate. _6, 4".2:1 N otary Public at Large, State of ` erso ublic,at - tiy Known County of rvl. :I Pro. ed Identifi :.n - tifi • Personally ti ' Produced .encation - + i Nota Si— w� �� ; -wr %�- —__ - - ` I Notary Si natur . *tit; i� c 'I A 't'e ix,t� cre "i:41....;;;-,..,41 * M ✓ COM SSION # DQ • ' ~— EXPIRES: Fe bn t a . . MY CO V I S S ION # 0 ; ,P' Bonded Thru N°t ry 14 2014 � r EXPI • DD 957780 aryPuh Underwr tern %1o F, • Bonded F ebruary /4,2014 °mil Puhlic Urg COAB FORM BLDG01: REVISED: 8/2/2007