Permit Roof 294 Poinsettia St 2011 T
4
C, C BEACH
CITY OF ATLANTI
X 11
- 800 SEMINOLE ROAD
sr)
777 ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 11-00002846 Date 11/03/11
Property Address . . . . . . 294 POINSETTIA ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3800
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Application desc
reroof
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Owner Contractor
------------------------
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SHOWCASE MODEL HOMES MANNY' S UNIQUE REMODELING INC
294 POINSETTIA STREET 8362 CROSS TIMBERS DR FL E 32244
ATLANTIC BEACH FL 32233 JACKSONVILLE
(904) 482-9565
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Permit . . . . . . ROOF PERMIT
Additional desc . - . 00
Permit Fee . . . . 70 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 3800
Expiration Date . . 5/01/12 -------
------------------------------------------------------------ --------
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 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 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: Permit Number:
Legal Description Parcel# 11��j �Ft
. .... ... .... Ft.
0 ed/cooled on-heated/cooled__.
Valuation of Work u' �Pr'pisjdWork heat
0 0
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Pte s—i d—e n—t i—all"N'
If an existing structure,is a fire sprinkler system installed? (Circle one 0 N/A
Florida Product Approval# product approval ro—rm
For multiple products use
Describe in detail the type of work to be performed:
Property owner Information: Address: 2-A 5-3 S:r'�
Name: 3
city ::rA— StateoELZip_12t�Phone
E-Mail or Fax#(optional)
Contractor In wmation:
lzev izent: a ri U
L b c:4r- Qualifying A
Company Name: ''I a.4119 State e-_=::Z_ Zip 32��
t Citv
Address: ;6.vl /--- 3
Contact Number Fax#
Office P�oneq_-041-4032.— 4!SA!�5 Jobsite/
State Certification/Registration �Z 10 2-7 73 9
Architect Name &Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
,it to do the work and installations as indicated I certify that no work or installation has commenced prior to the
Application is hereby made to obtain a pern in in this jurisdiction. This permit becomes null
fi d t the standards of all laws regulating constructic,
,(a permit and that all work will be per orme tomee ended or abandonea for aWeriod of sixp6) months at any time after
s, ells, Pools, urnaces, Boilers, Heaters,
issuance o f construction or work is su
rwork is not commenced within six(6)months, or i N
and void ij Electrica Work,Plumbing, Sign
work is commenced I understand that separate permits must be securedfor
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereb certify that I have read and examined thisapplicat'on and know the same to be true and correct. All provisions of laws and ordinances governing this
thority to violate o cel the
ranting of a permit does not presume to give au
type o work will be complied with whether speci ied herein or not. The g
101, of construction.
provisions of any otherfederal,state, or local law,regulating construction or the pe�formance
Signature of Owner-S!,21" Signature of Contractor xz;F
Print Name Print Name ..................................................................................................................................
. ............. ...................................
Sworn to a s c r e d before S�wor anc bed b ore e 2014
this 20 ___ t D
s
MI 6776
I 10N#D t ary 1 2014
Nota Bonded T Notary Public Und fiters bon ad Thru Notary Public nderwriters
Revised 01.26.10