Permit Roof 2233 Seminole Rd Unit 4 2012 • � rJu�
CITY OF ATLANTIC;► C BEACH
800 SEMINOLE ROAD
v . ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jli �
Application Number . . . . . 12-00000701
Property Address Date 6/05/12
OLE RD UNIT 004
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
-----Application-valuation . . 50
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Application desc--------------
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roof repairs
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Owner Contractor
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LA VACA INVESTMENTS LLC MULLIGAN CONTRACTING, INC
2139 LA VACA RD 6380 PHILLIPS HWAY ##'103
JACKSONVILLE FL 32217 JACKSONVILLE FL 32216
(904) 838-9868
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee
Issue Date . 00
Expiration Date 12/02/12 Valuation 350
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
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Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 59 . 00 59 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
W BUILDING PERMIT APPLICATION
CITY OF A'T'LANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904) 247-5845
Job Address: _ Z Z3 3 e 1- J �,ni T Y rmiit Number: .
Legal Description Parcel#
Valuation of Work$ oD oor ea o q. t. t
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/proposed strurtum(s)(circle one): Commercial esidential
If an existing structure,is a fire sprinkler system installed?(Circle one): s o N/A
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed:
Property Owner Information•
Name: /Dawse- �r�P–A-�C Address: Z�J3 ���t�tc/QLE l
City /L C t* Stat _Zip LZ; 3 Phone 70 3 - yL
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:
P Y eZZ6e,f/ Go�i�'�rTy,�y /,rte Qualifying Agent: 1,10<r
Address: >O�'"/��✓ �/ city ���,��/j StateOffice Phone��D Sfi 9,F1 Job Site/Contact Number —Zip� ZZ SCS
State Certification/Registration#_ �c.i?z y�j – $� -`��' Fax
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 her
made to obtain a permit to do the work and installations as indicates: I cert that no work or installation has conzn:e:aced prior to the
issuance of a permit and that all work will be performed to meet the standards of a111aws regulating construction in this jurisdiction.'' This permit becomes null
and void if work is not commefsced within six(6)months, or if construction or work is suspended or abandoned for apertod of siz((5)naantlar at any time after
work is commenced. I understand that separate permits must be secured for Plecirica! Work, Pluenbdng,Signs, Wells, Pools, Ftarnaces, Boilers, Healers,
Tanks and Air Conrlitioners,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 INTENT) TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR I®TOTICE OF
COMMENCEMENT.
1 hereby certify that 1 have read and examined t s a plication and know the same to be true and correct. A11 provisions o laws and ordinances governing this
type of work will be complied with h ther eci ted herein or not. The granting of a permit does not presume to e authority-to violate or cancel the
provisions of any other federal,stat , loc aw regulating construction or the performance ofconstruction.
Signature of Owner Sm
mature of Contra Mfr/
Print Nae l`
........................, /w�E Print Name
................................................................................... �r�s -......... ......... G.1....1. ... ...... ................
Sworn to and subscribed before me SwoFn to an s ed e re me
this Day of 2®
20
,•::�'rG SHIREY L GRAHAM
Notary Public oMMIssI I<ocssnso
*' EXPIRES:FedgqC
Bonded Th.Notary Public Un e t
ised 01.26.10
App ica e o es: 2 1R DAB NOT
W Pd T E 1 ELOW OFFICE USE ONLY
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Develoument Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments: