2056 Beach Ave 2012 roof r , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4 Jjilt-
Application Number . . . . . 12-00001036 Date 8/09/12
Property Address . . . . . . 2053 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO 3E UPDATED
Application valuation . . . . 600
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Application desc
roof repair at deck
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Owner Contractor
------------------------ ------------------------
HENRY DANIEL P MANLEY CONSTRUCTION GROUP INC
2056 BEACH AVE 11691 HAMPTON PARK BLVD
ATLANTIC BEACH FL 322335935 JACKSONVILLE FL 32256
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 600
Expiration Date . . 2/05/13
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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 kTLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANT C BEACH
800 Seminole Road, Atlantic!!Beach, FL 32233
Office (904)247-5826 Fad(904)247-5845
Job Address: AQ 5 Permit Number:
Legal Description -G Al afl LklJ 3 'Parcel#
11
oor Arc.,a ot sq. t.— Sq.Vt
Valuation of Work$ COCA_oU Proposed Work heated cooled non-heated/cooled 20
Class of Work(circle one): New Addition Alteration Rept Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fixe s rinkler system installed?(Circle one): es o N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: r l.ow Eojoe Qcoc
Property Owner Information:
Name: f e r\C\ v) k�e ►(' Address: e ti Ave—
city
vCi State FLZip a_13 3 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: n iTU(A%' Qualifying Agent: Zater- (tn 1y:j
Address: i U I ICity tcC�a rt-,u,"l State Zip 31r,>Se'
Office PhoneJob Site/Contact Number Qw6G 6 S3 Fax# 4&y-aZei-94'9,o
State Certification/Registration# CC C
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 hereby made to obtain a permit to do the work and installations as ind,Bated. I 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 als regulating construction in thisjurisdiction. This permit becomes null
and void if work rs not commenced within six(6)montorif cotuctionorworksuspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Ele cal Work, Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAIL TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOURYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO BTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFO RECORDING YOUR NOTICE OF
COMMENCE ENT.
I hereb certify that I have read and examined this application and know the same to a true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting f a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the per rmance of construction.
Signature of Owner Signature of Contractor
Print Name _...... ...................... ..........................._..-.................... int Name _.. _:..... ..........- - ......_.(
..........................
SwoM to and subsc 'bed before me worn t and subscribed before me
this D 2 1 t is I Day of AuGusT 20 12
Rr.......
�r,
EARLY 11 FL
.`r
Oldie 01
Notary Publi •: •= - n a rota Publ1c,State of Florida
oma, My Comm.Expires May 8.2015 p ry
°;' of«�`'• Commission# EE 91398 ComnAsiontEE148740 VtSed 01.26.10
My comm.worse Nov.27,20