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Permit Roof 1091 Hibiscus 2012 CITY OF ATLANTIC BEACH 1� 800 SEMINOLE ROAD .r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000813 Date 6/29/12 Property Address . . . . . . 1091 HIBISCUS ST Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5938 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BISHOP CATHLEEN M QUALITY DISCOUNT ROOFING LLC 530 GOLDENROD LA 1794 ROGERO ROAD NEPTUNE BEACH FL 32266 JACKSONVILLE FL 32211 ---------------------------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 5938 Expiration Date . . 12/26/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 84 . 00 84 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, 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 D 1 �- b ` tin fi L get,c.h, Job Address: t 1,sl,u�S ,S+ FL 31w��_Permit Number: Legal Description L{d~,3c/. ,� - S- �j� Parcel# 17/00e)-0(/� -T G o Floor Area of Sq.Ft. `� Sq..11 Valuation of Work$ 13 Proposed Work heated/cooled / a 7 non-heated/cooled 106P Class of Work(circle one): New Addition Alteration epair 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): Yes No /A3 Florida Product Approval# / S-1p. 1 T.$? o 9-7-X6 For multiple products use pro uct approval form Describe in detail the type of work to be performed: ©w f layer- dowel Property Owner Information: Name: l t7 Address- 3D gwtden rocJ CityState ISL Zip ( ((Phone E-Mail or Fax#(Optional) Contractor Information: Company Name: /4q �/�Lt?' un-t 19fC484 / Qualifying Agent: o_, Address:/ �IV nironn� ��/ City, - State Zip Office Phone 0�9�,�/�, �S� Job Site/Contact Number Fax# State Certification/Registration#_CCel�`?_ .$ Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address _/�i�n_1f;5' Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify 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= r abandoned for a period ofsix 6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, 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. I hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type ojYwork`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 regulating con ruction or the performance of construction. Signature of Owner Signature of Contractor Print Name p Print Name Ay. °— Cr1F-.� ........................................................................... . ......:.......h.....Z1� ............................... Sworn to and subscribed before me Sworn to and subscribed before me thihlql Day of 4 //,c 2_ 20 /1Z this Day of 20/ Notary Publi No aryPublic �P e'' SHEREE J.AMATt) r°. �V*s? Notary Public-State of Florida g}n;'�FeW soiidx3 wwoo AIN ., dMy Comm.Exoires Mav 1.2715 1 i _ �. . ,. • m n # =i Jun 29 2012 11 : 34AM HP LASERJET FAX p. 1 &v%0aA%--Ab Vin- U4Jfa=NC=I9N'I` REi4 j $ 1 (lM IN DUPIIC„TFC PortirdState No. Tax Folio No. . f C�Of To whom it may Oman n: Thr und"nod hl r Informs you that haprovwrenb wNi be made b"Mala reel P111110"My, aW in ar:eorelenor with 800111111001713 of the Florida 8tetutsa,the fopo t @ttormstlon Is stated In this M=g OF C=MEW=MT. Lepel descdptlon of property being Impro Address of property boldo improved: C,erreral desalptlon of Improvrrnents_ Owner Address L Owner's kftmd In alts of ft lmprovern m Fee shnpb Tidefloldor(it other then owner) Nuns Address Address Phone Na. Fnt No. Surety(if any) Address unt of bond i Phone No. Fax No. Marne end address of anY Person making a loon for the construction of Me Intprovenwk, Nome Address;tzt� Phone No. Fax No. Name of pwson within the 610111e of Florida,ether than hhmW deaipnabd by qww moo wfxes nM=or other doammts maybe served` Norio Address4999== Phone No. Fax No. In addition b h nnK owner deslpnetas INe fiDAwMnQ person b receive a copy Siouan 713A8(2)(b),Florida Statulea.(Fe in at Owner's epkn). at Liwwr's Notice as wed in Name Address Phone No. Fax No. Expkedon daft of Nodoe of Corrwnencemard pha�p date is one d arw�t dale is-; Med) (1)YOW*D rr the date of newdtng unless a Tuft!•PAC IrOR Rf[CORD Ow 2012135901,OR BK 15985 Pegs 807, a !,4Number Pages:1 �dryar to F Recorded 06/29/2012 at 12:33 PM, JNA FULLER CLERK CIRCUiT COURT DUVAL OY couNry s�.aa..w.ocSwein RECORDING$10.00 St hpr W� W-11y. ShIEREE J.AMATO P+eduadieaesieapwr �Notary pubNc•Slala of FlorldsMy Comm.Expires May 1,2015;,o��,�;•° COmrn18110n.#EE 89125