531 Selva Lakes Cir 2013 siding CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
� .::. INSPECTION PHONE LINE 247-5814
Jit
Application Number . . . . . 13-00002361 Date 3/26/13
Property Address . . . . . . 531 SELVA LAKES CIR
Application type description SIDING PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1400
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Application desc
siding
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Owner Contractor
PETTY, ROSEMARY JONSSON CONSTRUCTION
531 SELVA LAKES CIRCLE 333 SAN PABLO RD N
ATLANTIC BEACH FL 322334361 JACKSONVILLE FL 32225
(904) 591-0599
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Permit . . . . . . SIDING PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1400
Expiration Date . . 9/22/13
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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 60 . 00 60 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 64 . 00 64 . 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 Address: ��3/ S�'fJc! l �r �LY Permit Number: 13 - A�w
Legal Description 5,13-11 17giiIzs z9,_` -5re-lu;, Parcel#
Floor Area o q.t . —Sq.Ft
Valuation of Work$ /1 Proposed Work he'ated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existiug/proposed structure(s)(circle one):. Commercial Residential
If an existing structure,is a fire spri $ler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use pro ct approval orm
Describe in detail the type of work too be performed: V- 1'r/Jl�u'
Property Owner Information:
Name: r Address:
City Stated Zip 3zZ3 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Qualifying Agent: ��t gSOY7
Address: City State Zip Z,7.7
Office Phone 5r5'l- 3,;1Y Job Site/Contact Numbed � g Fax#
State Certification/Registration# 4;j� ,r /Z,r2>z0,
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 tf work is not commenced within siz(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,eta
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 here b certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether sppec`ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,st e, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor ('
Print Name > .. )S.C.... j. ..Y � .. ...... ................ Print Name
Sworr} d s bscri a Sworn to and subscri a befor ,me 0 i
this Day ti n2__
,-
o N:.tom•• SHIRLEY L.GRAHAMania
life
OMM:SION�DD 957760 `' ~''�, MARILYN M.DAVIS
No Public a` ExPi : e ruary o P 'c = _ Notary Public-State of a
vked 6tja iil ICE 156961
•?of •� Bonded Thru Notary Public Underwriters i• •-
- My Comm.Expires Jan 3,2016
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