Permit Roof 385 Sailfish 2012 CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001560 Date 10/24/12
Property Address . . . . . . 385 SAILFISH DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6100
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Application desc
Roof Replacement
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Owner Contractor
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SIMPSON, AARON L. INTEGRITY ROOFING SYSTEMS
385 SAILFISH DRIVE 5570 FLORIDA MINING BLVD
ATLANTIC BEACH FL 32233 BLDG 300 STE 310
JACKSONVILLE FL 32257
(904) 260-1372
--- Structure Information 000 000 REROOF
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Permit . . . . . . ROOF PERMIT
Additional desc REROOF
Permit Fee 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6100
Expiration Date . . 4/22/13
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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 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 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 Permit Number:
Legal Description3/-GYM/3��.S �-qq��• Parcel# 1713X'5_6060
F�Arehof q.F't
Valuation of Work$ : ' Proposed Work heated/cooled� 'non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): CommercialResidential
If an existing structure,is a fire sprinkler system installed? (Circle 4e . o /A
Florida Product Approval# GG/9'S6o / 6 GLL &_;;T
For multiple products use pro uct approvalform
Describe in detail the type of work to be performed:- RE-ROOF EXISTING BUILDING, SHINGLE TO SHINGLE
Property Owner Information: �^
Name:�}���th1 /cb '�« /'rt•�'G� Address: . 'S E
City StateA_Zip aa- Phone !26e 1?9'7 a EGD 50
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: INTEGRITY ROOFING SYSTEMS INC. Qualifying Agent: JOHN ALBRITTON
Address: 5570 FLORIDA MINING BLVD STE#310 City: JACKSONVILLE State FLORIDA Zip 32257
Office Phone 904260-1372 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 indicated. 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 all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within sir(6)months, or if construction or work is suspended 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 Electrical'Work, Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks 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 YOUR NOTICE OF
COMMENCEMENT.
I hereby 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
type o1 work will be complied with whether specified herein or not. The granting of 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 performance of construction.
CY
Signature of Owner
rJ a LID c�,o Signature of Contractor
Print Namen ,................_........_............ Print Name JOHN ALBRITTON
Sworn to and subscribed before me Sworn toAnd subscrihe o in
this 3,1d2 Day of 20/b" this Day of 20/,1—
N ary u he Not ublV C11
,.v+rvv .26.10
Qlv
Notary Public State of Florida ► nt. Notary Public State of Florida
Joy Marie Baldry i4 Joy Marie Baldry
My Commission EEo0757S �t My Commission EE007576
orf� Expires 071081201, hor p Expires 07/0812014
Doc # 2012220008, OR EK 16097 Page 1139, Number Pages: 1, Recorded
10/09/2012 at 09:20 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10.00
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Permit? e.
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THE U.M ERSIr NIED hereby gives netiea that improvenionts will be trade:to cehain realpropertiv,and in accoroaac.-wiia Se-lion
713.-11-1 of the Florida Statutes,-ft,-f*llo-,Ykgl indorniation is provided in this N:3TICE OF COTVIN - CEIMENT.
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i 0vvner Information
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N dine and address of fee simple titleholder(if other than oume)
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b)Telephone No 9tJ 2 t -.:372 _ftx'No.(Opt.) (90. ! 2-60-1359
5'surety infonnation _... _
a)Name and address:
b):Mount of Bond: ......_
c)'Tt-lephoac;i'o.: ._.__ P.ax Ilio.(Opt.) -
,G:Lender
Name and addmss:
Pbone Nall,
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a)Name and:address:
E b)Telephone No N _ Fes.hits.(Opt.).
SID au'dtttur.:o himsel.k olAmer designates the.fallowing parson to reweive a copy of the L:enor's natio:;as proeidcd in Section
Florida Statutes
a)Ike and address:
b)Telephone No,: _ _ _ fax No.(Opt) _
9-47viration date of Nod=of wotn.�uencernent(the expiration date is one year from ae date of recording Emless a dWarent date
Wlt,R?441`si'f 'I'O O YYf'NE R': ANIY I'AIWIE�Q I S IXLADE S TETT O'�4',til?:R PIER TqE.LXPI&A TION OF TIILNOT ICE s`F
COMWEENCEINIENT ARE CONSIDERED LNWROPER F AADS a4•II: T.15 UNDER CHAPTER 713,P.ART'L SXC�ION'13,1:3,
V�ZYOURI HYING TWICE.E£Il"x IMPROSEMEN z S r fy YOUR FROP:I`cTY`
A NOTICE OF C43MMI .-ENCENi ff-M MUST BE RECORDED AND FOSTER ON'TUE UE OB SITE BEFORE THE F £8 T
L,'4SI-Et.,rION>.Ir YO;1--s"Tvic-D TO OBTAIN FUSAx'tit EINE,CONSY;-T YOUR LEINDE3e OR AN AWf3RNWY MFORE
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titto 5etion 92.525,F!olldii Stat tl tez.Under p,,maLtles of Ped urjy.1 �l1kt
the facts stated in it are nue to the best of Inn knowledge cacti bel eft
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