Permit Roof 1652 Coquina Pl 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000872 Date 7/11/12
Property Address . . . . . . 1652 COQUINA PL
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3380
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Application desc
REROOF
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Owner Contractor
-
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FEDERAL HOME LOAN MORTGAGE INTEGRITY ROOFING SYSTEMS
5000 PLANO PKWY 5570 FLORIDA MINING BLVD
CARROLTON TX 75010 BLDG 300 STE 310
JACKSONVILLE FL 32257
(904) 260-1372
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3380
Expiration Date . . 1/07/13
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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 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 Pll�RMFT APPUCATION
CITY Ole ATLANTIC BEACH
800 Seminole Road, Atlantic Reach, 1,1, 32233
Offlice (904) 247-5826 Fax (904) 2247-58,45
I
� T�i6urufirSS: S ( G �� r
rrtit Number-
Legal
nm er-
Leal
-- __—
Descri ftiort 1,11V)7- A4C/ Parcel # A(
oor rea o _ q. Vt. q• t
Valuation of Fork S 3,���iX D. Proposed Work heated/cooled� non-heated1cooled 5 %
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Reside_ nth
If an existing structure,is a fire sprinkler system installed? (Circle one)_F des No N /A
Florida Product Approval 4 fL- 79 9,.S
For multiple products use product approval form
Doscribe in detail the type of work to be performed:- Rt ROOF EXISTING BIJILDING. SHINGLE TO SIIINGLI-:_
faro ert-v 0-, ner information:
��,Gc,�9�-- /!fit Ll�rr9� • -
Naine: 0047zL F CytPA)e4rp u _Address:__.S&_e& -
C ity ✓ +r j2t3—_-- Statc ip i.Sr u .PhoneQD y 4C 9 6 Ifo
1:-Mail or Fax#(Optional) -
Contractor Information:
Company Name: INTEGRITY ROOFING SYSTEMS, INC. Qualifying Agent JOHN ALBRITI ON
Address: 5570 FLORIDA MINING BLVD STE� 310 City: .1ACKSO\�'1LLI _ -_ _State FLORIDA Zip ',-'12D7
Office Phone 904 260-1372 Job Site/Contact Number — Fax" 904260-13_51___
State Certification/Registration i,' -_ C:CC1329865 —
Architect Nalne&Phone#
Yngineer's Name& Phone ti
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortliage Lender Name and Address
,4pplication is hereby made to obtain a permit to do the work and installations as indicated. l certUf that no work or installation has commenced prior to the
issuance of a pernzit and that all work will he petformed to meet the standards of all laws regulating construction in this.jurisdiction. 1 his permit becomes null
and void;1 leork is not commenced within six(6)months, or irconstrucdon or lvork is suspended or abandoned f or a��eruid Uf six(6/months at arzv Time a%ter
work is commenced I understand that separate permits must be secured for Electrica 5i orl:, l'lutnbing,.Signs, ells, Pools, Furnaces, dfo9dehv, ddeaiers,
Tank-v and Air Gottditioners,etc.
WARNING TO OWNER: FOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO FOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
FOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 herebi,cer•ti?-!fiat t have Eu stn I t-aMired this qpiicat'.on andknow the saine to be. ar:d t-ca l!pro.';"r::rs Of IalvS and Gr�l It CEa"�ll'el'nird Ii7iS
tyre of work will be complied it whether specified herein or not- The granting of-a permit does not pr•esunze to gree authority to violate or cuncei the
Ov—
provisions of anv other federc ,si e, or local fal9. e lulaiirzg construction or the perfor-inarree of construction.
+, "L . W Signature of Contractor
Signa=c ofowl - _
Prail E`�'arne o e r
+ t. /4+k: r L ?rint Name JOfTNT ALBR. t VON ......
Sworn t all subscribed before ane Sworst I. � nd subscribed before me
this�Day of Aja � --—,20 1� this ay of _ SIJ! 2QG�—
�lotary 1't�blic Notary I' ]c
ow 1r,. (Votary Public Stas of Flonds
�a�aY past,,+ JUDITH 765ATESto Marls Baldry
Pz Notsfy Public- Florida4My commissan EEoo7S76
$ My Comm.Expir10,2014 ' Fxpirss 07108/201,,
71, 11t 1Commission# 9100 °r
Doc # 2012142026, OR BK 15993 Page 2360, Number Pages: 1, Recorded
07/09/2012 at 10:53 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10.00
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