1945 SEminole Rd (vault) ITY OF ATLANTIC BEACH
FING PERMIT APPLICATION
JOB LOCATION: l �l S, S e rn`.\ c,/C_ Kle /`-
OWNER OF PROPERTY: TELEPHONE::
CONTRACTOR:
CONTRACTOR'S ADDRESS: 5 A/ 4 /G
13,X f / ZIP: a 7`7
STATE LICENSE NUMBER: PC C90 z/5_'le 7 —TELEPHONE: ?U`1-/3`/
DESCRIBE WORK TO BE PERFORMED:
305v -'hc �• �' �—
VALUATION OF PROPOSED CONSTRUCTION G/, -Z S c. C,v
MATERIALS TO BE USED: .2 "0 f`-�
SIGNATURE OF OWNER: \v "
SIGNATURE OF CONTRACTOR: `
f �
N T�A�®1$�69LIMME BEFORE ME THIS —DAY OF t9
WSTATEO
COMMISSION # CC786
EXPIRES OCT 27,2002 A ,
DED THROUGH ,t
OWNTAGE NOTARY f'
4AIS
TARY PUBLIC
SWORN TO
AND SUBSCRIBED BEF REM DAY OF v
_
AS TO CONTRACTOR
TARY PUBLIC
Liability Insurance Supplied
NOTARY
JAMES T. BEE-CHER Workers Compensation Insurance Supplied o°L° EXPIISSION # CC786RES OCT 27,2002
_ BONDED THROUGH
Contractor License InfOmlation Supplied ADVANTAGE NOTARY'
Occupational License Information Supplied 0
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road - Atlantic Beach, FI 32233 - Tel. (904) 247-5826
ROOFING PERMIT
.,
-7—PERMIT INFORMATION m T I 4` OCA I TON-INFORMATION
t P-ermit'Number: :`+23492_ _-_-y m ,W � i Address:-LL f 945 SEMINOLE ROAD-
-------
Permit Type: RE-ROOF ATLANTIC BEACH, FL 32233
Class of Work: NEW Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision: NORTH ATLANTIC BEACH
Est. Value: Parcel Number:
Improv. Cost: 4,250.00 OWNERt1�FORMATION
- -, .��
Date Issued: 2/15/2002 ame: 1AV1D__ 'LUCAS-
Total Fees: 51.00 Address: 1941 SEMINOLE ROAD
Amount Paid: 51.00 ATLANTIC BEACH, FLORIDA 32233
Date Paid: 2/15/2002 Phone: (904)247-5415
--- or esc: ODF - - --
r�. - CONTRACTOR(S) -71111111�11-4-1x��41
t Y
�HATHA OOFING--COMPANY` or
r ,�, � 1-._ � .�� ..,y-ti t��°ms's•
� Y �
-�4a Wr'1a* uf�gd'. *. '^ `Tr•. -teTaJs :y
' �„a_w'7+ T���_k� ;�'�i� ''°Y3.��• �' e s �"�s 5 ��<3.v y,T ."'�RfK
ryAf
NOTICE- I I. STR + PECTION
BUILDING MATERIAL x lH ) QfidE1Tf�]Dfi IES IC SPACE, AND
MUST BE CLEARED 1. 'EQR
ry 64
46
"FAILURE TO COMPlr lAf '1' �' IN THE
PROPERTY OWNER P ., BU* NG IM
ISSUED ACCORDING TO APPR EA _ S E SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE V4FLA
oper: CHERYLE Type: GC Drawer: 1
3517
Date: 2/28/82 81 Receipt no: (51988
nu�ber:
14 Pnumb S:BUILDING 1 78%76
Trans (51.88
CITY OF ATLANTIC BEACH CA CASH
ran '