Permit Roof 350 Ocean Blvd 2012 CITY OF ATLANTIC BEACH
N� 800 SEMINOLE ROAD
p; ATLANTIC BEACH, FL 32233
. . - INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001623Date 11/02/12
Property Address . . . . . . 350 OCEAN BLVD
Application type description ROOF PERMIT'
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 10375
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Application desc
REROOF 1956 . 3
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Owner Contractor
------------------------ ------------------------
GALLOWAY CHARLES M & BARBARA L SHORE ROOFING COMPANY
350 OCEAN BLVD 914 7TH AVENUE SOUTH
ATLANTIC BEACH FL 322335336 JAX BEACH FL 32250
(904) 241-8842
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 105 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 10375
Expiration Date . . 5/01/13
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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 105 . 00 105 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 109 . 00 109 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. r
09-
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date: 11 ,1
Job Address:so d GCG N (My `
---Owrwvf-Property n 1•^ i•L (;A l n W a�•l
Address �7 wid My V' Telephone:
Roof Contractor. Short r od(_ State License Number. C(y,6SY 1l
Contractor's Address: J l �� Avis,
s
Telephone• Q 4 I`a- �I�•' Fay Email,
Scope of Work: RJocfE Roofing Material �►+"S��
FL Product Approval#_/93�•3 Valuation of Wort-- $ /CS,• 7S
Required Inspections: Sheathing/in Progress-Dry In /Final
If re-roof: Assessed Value of Structure:Z<$300,000/>$300;000;Roof-tomal)improvements required?
{Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT/N YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE!OB SITE BEFORE THE FIRST INSPECTION. N YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY B FORE RECORDING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER: f7 " Date:
AS TO OWNER:
Sworn to and subscribed before me this of
5�tdtif�Fii�A•iBh1JY�ibi`tht�P.IIuval
a'PYPUBLIC Notary's Signature: a1�)i �'�`-�:`x —
` * r ax i I L?RIi3A ❑ Personallyknown
tern* # X09 3'r3 Produced Identification
-;sa7a, 1 ;a O <° Type of identification produced
-- SIGNATURE-OP CONTRACTOR:-- Date:
AS TO CONTRACTOR: h,
Sworn to and subscribed before me this tl 1 o_day of Q.0�r>)D e f .20_A_j.
State of Florida,County of Duval
Notary's Signature: , 1Oh � �l l� •\ -Va
Personal known
❑ Produced identification
Type of identification produced
aOAR,)ORIE-N1,ADAMS-HARRUp
c t N0,rp Qy PUBuc 800 Seminole Road•Atlantic Beach,Florida 32233-5445
ST A 7 E OF FI ARIDA Telephone: (904)247-5800•Fax:(904)247-5845
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NOTICE OF '6,0 NT
BARE IN MFLIrA ,
Pemt Na Tax polo No.., OOOd
State of cmxvy of ._.__.
To whom S may conoWw
Mwe ---'--dhwaft&fc you hnprowmente vrl8 be made�o oeNain rod property.sswd in
accordwWwNh Sao=773 of the Hodder .the following NdbnAlan ie staled In'tMs NOTICE OF
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Address d bekg bWv eed S 0 2S_"nl 3.(.v
GenereldesalpUanofkrpvvenwrds: `G
owner
owner's mierest kt ske of the knp wAfflerd
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Phone NM Fax No.
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Address Amount of bard S
Phew No. Fax No.
Name OW address of any person maktn9 a Mart forthe oaadrucllllono knproveme"lls. ,
Nana
Address
Phone No. Fox No.
Name of person vAhin the Blab of FlorMs.odwrthon hk mff,desipnded by owner War whom nadoes or other I
downents Tey be saved:
Name
Address
Phone No. Fax No
I
In adom 10 trknaelf,owRwr dasigndw the Mo wkr8 person to leodw a copy of the Liarors Nodw as provided in
Section 713.08(2)(b),Flodda SWutee."In at Owner's option).
Name
Address
Phone No. Fax No. -
eq*Won date of Notice of Commencement(the expW n dde b arra(1)yew tcm the date of recw*V unless a �
Abrent date b spedlied):
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Doc#20122}5379,OR BK 16128 Page 2050,
Number Pages: 1
Recorded 11;02 2012 at 12:38 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL sn� :�L O0"'�►0F
COUNTY
RECORDING$10.00 Piodiomdtd (_lllf C,-
KiRt�n 4'ftK! 1Rd€ iA.ADAMS-HARRUP
NOTARY PUBLIC
STATE OF FLORIDA
Comm#DD0933778
0/30/2013