Permit Roof 329 11th St 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000891 Date 7/13/12
Property Address . . . . . . 329 11TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 875
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Application desc
ROOF REPAIRS
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Owner Contractor
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HAYES, JARROD BRC HIGH TECH ROOF DIVISION
329 11TH STREET 6372 GREENLAND ST STE 6
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 875
Expiration Date . . 1/09/13
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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
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total . 00 . 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.
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 14 -,A
5 a Parceig
Floor Area ot Sq.Ft. Sq.1,t
Valuation of Work$ 9 7S Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration I(Repai�r) Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinklee system installed? (Circle one): Yes No N/A
Florida Product Approval# ( 'F-(4 .'3
For multiple products use product approval form
Describe in detail the type of work to be performed:
Property ftner Information:
Naine:144A44 &:�w Address:
City 6.4k" Stater Zip .2 Phone J90 q - &17-.4 7.6
E-Mail or Fax#(Optional
Contractor Information:
CompanyName: Qualifying Agent:. JA!�4ft
Addressli-ov ok S 1,A,' i7rove-AV 54.fre it i 0,9iry- City LT44AAPA4_� State Xt Zip7 2 7 57'
OfficePhone fa�t ).rroy21 Job Site/Contact Number .-Fax#
State Certification/Registration# CC--C 0-P&3?A
Architect Name&Phone#
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A her ad a, a do th k a in alloa nd d fy h a n rk or installation has commenced prior to the
e wor st 0 s c erti t 'u owo in this jurisdiction. This permit becomes null
2str ctio
us 0 or
a� lucaband qd� a eriod ofsq6.,months at any time after
c
p""' s ting
r c n to ti sd s de 0,
e" e erm t 0 me es ' law
k Ilb dtom ta ds a
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s or
f h s r"t, 0 k s
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0 0
p"c 'io is e Y mi th Iwo e
e a per_7 a a a U(6 '0't on r or 1� P S.
e 1 0 lectri r 'ng' 1gts, t
ss c 0 It , t an r w ep) d rE k d1s,Pools, urnaces,Boilers,Heaters,
a d �d -0 k i s ot" men ed w thin s
f d� I, der t d that separate Per, s t be Secure ca
,' '. ,' . 'c
,k i 0" s
T n r C itio
anks a d A, on ners,etc.
I 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 here certi I the
'1b fy 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
work will be complied with whether sped or not. The granting,of a permit does not presume to give authority to violate or cance
f
ied herein
provisions ofany otherfederal,state, or local law i�egulating construction or thepe�fbrmance ofconstruction.
Signature of Owner lz= Signature of Contractor
r
Print Name, Print Name
....... ............ ..............................................
.... .. ... ....................
.......................................................................................................................................
Sworn to and subscribed before me Sworn to and subscribed before me
this 0�0�4Day ot-- 0- , 20 Id- this /3-*-Dayof - 20/-)-
V Al.
Naiarj0+Wc- S. BRIAN HYNES
H ES
MY COMMISSION#DD947667 My COMMSSION#DD947667 evised 01.26.10
EXPIRES December 17,2013
EXPMS Decernhmr 17
Floridallotaryservice.com (407)398-0153 FkW1daN.t._-__.;__ .2013