Permit Roof 437 Skate 2011 �,c,
J
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
Property Address 11-00002839
Application t 437 SKATE RD Date 11/01/11
y Zoning
Property type description ROOF PERMIT
Application valuation To BE UPDATED
------- ------- --- 7000
Application desc ----'-----------
REROOF ------------------------
Owner------------------------ Contractor
HOOD, GREGORY -------_ _
437 SKATE ROAD GREAT WHITE CONSTRUCTION INC
ATLANTIC BEACHFL 32233 4320 DEERWOOD LAKE PWy-----------------------------------
____ ______________ _ JACKSONVILLE FL 32216
Permit ROOF PERMIT -----------------------
Additional desc . ___------
Permit Fee REROOF
Issue Date 85 ' 00 Plan Check Fee
Expiration Date Valuation . 00
----- ------------- 4/29/12 7000
Other Fees ----------------------------- --- _________
STATE DCA SURCHARGE -
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged------------------------------------2 . 00
----------------- ---- Paid Credited
Permit Fee Total --------- ---------- Due
Plan Check Total 85 . 00 85 . 00 . 00 --
. 00 . 00
4
Other Fee Total ' 00 • 00 . 00
Grand Total ' 00 4 . 00 . 00
89 . 00 89 . 00 . 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 B
800 Seminole Road EACH
Office 904 � Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 37 5{rt �
Legal Description Permit Number: // 2d"
Valuation of Wor $ 7 o a� oor k 3
_ rea o Parcel#
Proposed Work heated/cooled
Class of Work(circle one): � t
New �—
non-heated/cooled
Use of existin / ro Addition Alteration
If an existingg P °Sed structures Repair Move Demolition
struc ure,is a fire s rinjircle one): pool/spa window/door
Florida Product A P er system installed?mercial Residential
For multiple pproval# �°!,1 (Circle one): Yes N/A
P products use product a No
Describe in detail the type of work t be oerfo me
p rmed:
Pro nerty Owner Information
Name: r.
-i Ca�,�3� c►-, Address: q,3-1 Ska.
E-Mail or Fax#(Optional) State -Zip Z-U
-3�_Phone 4
-ontractor Information:
,ompany Name:--r_����
Lddress:_LL ce - "` `T Qualifying Agent:
)ffice Phone a( �g�.1 t,s 9 State FL
Job ite/r'ont�,.�,.T...�,_Cih'�k
tate Certification/Registration# cc.c "�`a.0"'ver 9Ot( 138-14 s-1 Fax# --Zip Z, t
Lrchitect Name&Phone# fou
',ngineer's Name & Phone#
ee Simple Title Holder Name and Address
londing Company Name and Address
9ortgage Lender Name and Address
;plication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
nuance of a permit and that all work will be performed to met the standards of all laws regulating construction in this jurisdiction. This permit becomes null
Id void If work is not commenced within six 6 months, or if construction or work is suspended or abandoned for a period of six p6)months at any time after
ork is commenced. I understand that separate permits must be secured or Electrical-Work,Plumbing,Signs, Wells, Pools, urnaces,Bollers, Heaters,
inks And Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
ToCOMMEINCEMENT
PROPERTY IF YOU INTEND TO OBTAIN FINANC NLT IN YOUR PAYING TWICE OG, CONSULT WITH
TO YOUR PROPERTY.
YOUR LENDER OR AN ATTORNEY BEOR ENTE RECORDING YOUR NOTICE OF
COMMEiereb certify 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
�e o work will be complied with whether specs sed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
ovisions of any other federal, e, or local law regulating construction or the performance of construction.
ignaturep wne 0) Signature of Contractor 'L
Tint Namet�D ,/ Print Name 1i(-C;vSa�c11kY
worn d subsc d it be me Sworn to and subscribed before me
►' D 20 this y of v 201
„ .,,, p1AANDA
lotary Pu y �, rnm Notary PubecAl"MO:May IC 'underwrilers =: S:MaYwk u�"+"l�s
no"dedTh" � Revised 01.26.10
J'-/ S -7/ 3 0 -0
1jG41133401 1 //— C) Cl PAGE 01/01
State of OF
_. .._...._ _,�
Doe#2011238357,OR SK'15757 Page 2459,
County of Number Pages: 1
Recorded 11/02/2011 at 09;07 AAA,
To�om It may Concern JIAA FULLER CLERK CIRCUIT COURT DUVAI.
'COUNTY
The undorsigned herebyRECORDING$10.00
the Plorida Statutes ,nfoz�ns you that im
Legal Description o ftho followi09 information is stents will be Made to
Property be1n fated in this NO7'i certain al P
g improved.: CE Op CO jPNC.M.8NT, in accordance with Section 713 of
Address of properly being i roved:
General descri tion p o ed:
p of im.proVeTuents:
Owner:
Owner's interest in �lddross:
site of the
Fee Simple Titleholderif I
( other than o Amer):
Name: -------
Contractor.
Address,,`cA baU
_,=%. 1.Q.y„� �
Telephone No.:_�d`� eE.
Sur �3�»!i. � *cap
ety(if any) Fax No: b t
Address:
� 600
Telephone No:
dress
Name and ad �_Amount Of of S
ofany Eton F
maki ax Na:
Name: nS a loan for the conatzTaotion of the improve s
L
Address:
Phone No:
Name of person within t1�g State of hlorida Fax No:
served: > other than h.,i- '---_�
Name: mse.If„ deg' by own.e upon.whom notices or other docs,
Address: aQenta may be
Telephone No:
In addition.
to himself, owner designates the rax.No;
""06(2)0)),Florida Statues. ,fodo�' l; persou
. to receive a�o
Name: (Fill in at Owners option) PY of the Lienor's Notice as
Provided in Section
Address:
Telephone Flo:
r(ec on date of Notice of Commartcemonr the e Fax No: �I
epoci ed}: ( expiration date is oneI
(1)Year froth the date of recording unless a difFerent date is
THIS SPACE FOUR RECORDER'S USE ONLY y
OWNER
Si{T0 da
NDAWHITE OfFloridghas cr�nrlp,il a ea ALL tY
MY COMMISSION p EE057349 p• - y PP _r in die Coun of TaUv SfA1B
EXPIRES:MPur>IIoUn�ar�rsnm Notary Public at Large,State of F101 ida,Conn fb vel. �0 0 r�
I,*NOM My commissiab cxpfits:
Personally T,-Uown: .._
�'m0uccdlde ti�icat►o �or