325 Country Club Ln 2013 roof CITY OF ATLANTIC BEACH
iJ 800 SEMINOLE ROAD
J
r� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
13-00002457 Date 4/11/13
Property Address . . . . . . 325 COUNTRY CLUB LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3000
-------------------------------
Application desc
reroof
--------------
-- ----------------------------------------------------------
Owner Contractor
--------------
------------------------
----------
GROVER, WILLIAM HOWE JR HOMEOWNER BLDG SVCS INC(ROOF)
325 COUNTRY CLUB LANE 739 BROOKMONT AVE E
ATLANTIC BEACH FL 322335502 (9KSO07) VIL E FL 32211
---------- -----------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 65 . 00 3000
Issue Date Valuation
Expiration Date . . 10/08/13
------------------------------
Special Notes and Comments
NEED NOC
---------------- 2 . 00
Other Fees STATE DCA SURCHARGE 2 , 00
STATE DBPR SURCHARGE
___---------------------------------------------------------
Fee summary Charged
Paid Credited
_ ------- . 00
----- ----------
- . 00
Permit Fee Total 65 . 00 65 . 00 00 . 00
Plan Check Total • 00 . 00
4 . 00 4 . 00 . 00
Other Fee Total 00 . 00
Grand Total 69 . 00 69 . 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: �Z �o� y,JT RT9 �,� r LA-x)z- Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 3Proposed 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):. Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N /A
Florida Product Approval # 4: C- Y7 9.1
For multiple products use pry ct a-prova ,orm
Describe in detail the type of work to be performed: Z ir7ao� F c t47- 0 I-IC JZ
Z,-�r&'7W6 S pyocc
Property/I/Owner Information:
Name:
Tse Gloms✓L/Z Address:
City >1.r«►c�y State Zip Phone
E-Mail or Fax#(Optional)
Contractor Information: `/ / �s p
Conipanv Nanie: / "'?fir NSR azekP7� J_gn'A—C'�S QuallfVlii� Agent: 61-4 ✓'V
Address: 73S A-yt , r. _City :3V State t-(-• ZIP-121?-�z—
Office Phone 3Z� Job Site/Contact Number 737-2- ,y:V Fax#
State CertificationfRegistration # CC-C- 1_3 Z8**I�l _
Architect Name&Phone#
Engineer's Name&Phone i+ `—
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made!o obtain a permit to da the work and instadlaltons as indicated. I certify that no work or installation has commenced prior to the
issuance of a perms[and that adl work will be performed[o meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced x�thin six(6)months, ,r if constn�etion nr work is suspended or abandoned fr�r a�errud of six j6)months at any rime after
work is commenced /understand that separate permits must he secured fvr Elec?rica�t Work, Plumbing, Signs, ells, Pools, urnaces, /3riiler, Heater,
Tanks and Air Conditiarers' a
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.
1 hereby certify that 1 have read and examined thisapplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether Specified ed herein or not. The granting of a permit does not presume to authority to violate or cancel the
provisions of any other federal,state r local w regulating construction or the performance o/construction.
Signature of Owner Signature of Contract
Print NameIl .._.................. -- - - - Print Naive �G t�.� ........R'---0,; '. ,1 ....
SW o and subs a be re me Swo and subscribed be ore ire
20 thi ay.of 20
P" EANN L. �_ NN L RO N
r° r'
Awe omm.Expires Oct 11, 016 114 My Comm.Expires Oct 2016
;�• Commission OFF�d: Commission#EE 8
OFF #EE 842758 4 758•
eves 01.26.10