650 Plaza roof 2012 r� CIT OF ATLANTIC BEACH
r�
800 SEMINOLE ROAD
J � ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
i
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Application Number . . . . 12-00001155 Date 9/04/12
Property Address . . . . . . 650 PLAZA
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7795
----------------------------------------a------------------------------------
Application desc
REROOF
---------------------------------------- ------------------------------------
Owner Contractor
------------------------
------------------------
HUPPMAN KATE L INTEGRITY ROOFING SYSTEMS
650 PLAZA 5570 FLORIDA MINING BLVD
ATLANTIC BEACH FL 32233 BLDG 300 STE 310
JACKSONVILLE FL 32257
(904) 260-1372
-------------------------------------- ------------------------------------
Permit . . . . ROOF PERMIT
Additional desc . .
Permit Fee 90 . 00 Plan Check Fee
00
Issue Date . . . . Valuation . . . . 7795
Expiration Date . . 3/03/13 j
--------------------------------------- ---------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ----------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
I�
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904) 247-5845
�,oc�zR- C.
Job Address: f Permit Number:
Legal Description A r.2 ZrTi� 6 w Parcel# -4Wo
Floor Area o q. t. q.Ft
Valuation of Work$� Proposed Work heated cooled non-heated/cooled 31
Class of Work(circle one): New Addition lteratio Re it Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed?(Circle one): es No N/A
Florida Product Approval# F- --j01A
For multiple products use product approva form f
Describe in detail the type of work to be performed:_ RE-ROOF I EXISTING BUILDING. SHINGLE TO SHINGLE
Property Owner Information:
Nalre:4PE Address.
City hWAA177L 6�_'O Statq -Zip_Jol-" Phi ne !s`
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: INTEGRITY ROOFING SYSTEMS INC. Q' alifying Agent: JOHN ALBRITTON
Address: 5570 FLORIDA MINING BLVD STE#310 City: JAC SONVILLE State FLORIDA Zip 32257
Office Phone 904 260-1372 Job Site/Contact Number Fax# 904 260-1355
State Certification/Registration# CCC1329868
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 indi ted I certify that no work or insttujut#on has commenced prior to the
issuance of a permit and that all work wilt be performed to meet the standards of all la s regulating construction in this jurisdiction. This permit becomes null
and void tf work is not commenced within six(6)months, or if construction or work is nded or abandoned for a_period of six5)months at any time after
work is commenced I understand that separate permits must be secured for Electri Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILU TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR P YING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO O TAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFO RECORDING YOUR NOTICE OF
COMMENCE ENT.
I hereby certify that 1 have read and examined this plication and know the same to b true and correct. .411 provisions of lmvs and ordinances governing this
type of work will be complied with whether sppeed herein or not. The granting o a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local taw regulating construction or the perfor ance of construction.
Signature of Owner L� — Signature of Contractor
i
Print Name We. Rjr1gC15+e,1.1� Print Name JOHN ALBRITTON
.........._. _. ................._.....J.... . . _............................................................................_.....................................................
Sworn to and subscribed before me SIA Zorn to and subscribed before me
this/ Day of"A16asT 20/Z thi l7�Day of �,e S;— .2012-
S
No _ P lic
N ary u is
►tom Notary Public State of Floridaevised 01.26.10
Joy Marie Baldry dY►EjExypire
ary p�b1iC State of FloridaFlorkia
K My Commissior_E007578 yf' Maris Baldry
�+ Commission EE007578
or ri Expires 07108/201 s c.
��or r s 07!0812014
Doc # 2012178553, OR BK 16041 Page 1131, Numb 'r Pages: 1, Recorded
08/21/2012 at 10:11 AM, JIM FULLER CLERK CIRCUI COURT DUVAL COUNTY RECORDING
$10.00
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