Permit ReRoof 330 11th St 2012 'e V I . I
IN15
C, 011
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001401 Date 9/27/12
Property Address . . . . . . 330 11TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5991
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Application desc
REROOF
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Owner Contractor
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JOHNSON B ET AL QUALITY DISCOUNT ROOFING LLC
12321 BUCKS HARBOR DRIVE 1794 ROGERO ROAD
JOHNSON DWIGHT W JACKSONVILLE FL 32211
JACKSONVILLE FL 32225
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5991
Expiration Date . . 3/26/13
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Special Notes and Comments
NEED NOC
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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 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 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
KOULLIJUNU rhJKiV11 I AFFLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
)b Address:��D /J�� �St_ "adfi(_ bWh
egal Description permit Number:
110 -f2l� Parcel# / -11 ao?- 1"(j
1 0 C Floor Area of Sq.Ft �iq.Ft
aluation of Work $- 1�—>1491 Proposed Work heated/cooled 111q non-heated/cooled -V 4?
lass of Work(circle one): New Addition (2�tFraiii6n f=Repair Move' Demolition pool/spa window/door
se of existing/pro osed structure(s)(�irclle one): Commercial lj�sid�e. tZ�
an existing structure,is a fire sprinkler system installed? (Circle one): e�, No
orida Product Approval# /41,5 6, /
)r multiple products use product approval form
escribe in detail the type of work to be performed: eemi2ve- I t"6� --;110uj4 -tO r-wr' dec4- 1.2e-- A14d I
V
(fit& O&Y
F --.g vi'm IY90-9 �Tdh �ks:!� ai ich
*operty Owner Information:
ime: AA lf`C4 hf I J t,7efQK) Address: 1,?AA
ty - State,!EL-Zip--?±3�Ph
-�Ia4!Lm o 48 —
Maif-or-FaK#(optio' nal)
)ntractor Information:
zip -3 1�9-al I
igineer's Name&Phone#
e Simple Title Holder Name and Address U
)nding Company Name and Address
ortgage Lender Name and Address f,14r)1U&
olication is h made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
-4ance of ape=nd that all work will bepedbnned to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
i void if work is not commenced within six(6)months, or if construction or work * u ended or abandonedfor a f six(6)months at any time after
4 _period o
rk is commenced I understand that separate permits must be securedfor ElectricsaMork,Plumbing,Sios, wells, Pools, Furnaces, Boilers, Heaters,
nks 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 YOIKk NOTICE OF
COMMENCEMENT.
�re�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
work will be co�nplied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
,visions of any otherfederal,state, or local law regulating construction or the peiformance of construction.
rnature of 0wneAL=1-1-,--4,4�4--- Signature of Contractor
nt Name Print Name,
��jQha5 6 ............2
..... . ....... ............. k-4�......... .........................
,orn to and s 'be befoKe me Sworn t and subsmbe efore m
s 0 P!9 2011Q JIA&A,-
-L�,_) ,Day this Day ofj 20 1A
, �A i�j '00
sub 0 b
D?be be,,
eZ) 4ZMIIL60
,tary '55-lic ........ aryTqu ric
SHEREE J.AMATO
Notary Public-State ofFlorida ..
01
215 26
y 1� ;da
SHERER0,AkWl.26 0
F MY comm.Expires May 1,2015
89 lo'
Notary Public-State of Florida
25 201 5
My Comm.Expires May 1,2015
commission#EE 89125
Commission#EE 89125
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