222 Pine St 2013 roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003564 Date 10/23/13
Property Address . . . . . . 222 PINE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 11780
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Application desc
reroof
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Owner Contractor
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JOHNSON JOHN & DEGEN MICHELLE RAVEN ROOFING LLC
222 PINE STREET 6772 ARCHING BRANCH CIRCL
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258
(904) 237-17S8
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 110 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 11780
Expiration Date . . 4/21/14
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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 110 . 00 110 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 114 . 00 114 . 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: Z,47- Plorc �rl. en&mL -g&qq+ 3z7-3,y Permit Number:
Legal Description /0-10 fob-mye 5& 3 Parcel # RO 3i>7-006tr5
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 1117150, 1�0- Proposed Work heated/cooled 1'7,s? non-heated/cooled �qq I
Class of Work(circle one): New Addition Alteration (��e_pair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial esidential
If an existing structure,is a fire sprinkler system installed? (Circle one):E;�isPo N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: 915 - 4or
Property Owner Information:
Narne:,, imit44aL& �W"P, Address: po,�c !ST.
City 81VAMIL WtH StateffZip ? !S� Phone qr75_146�0
E-Mail or Fax#(Optiona
Contractor Information:
Company Name: _k) &F,it* Qualifying Agent: 7fib-1 Lice
_�mh,?Jjq T:tmD W city -VAtLS6)UV1 LLE
Address:- -State QL zip 3-zz-v-
OfficePhone 12714 Job Site/Contact Number 15 Fax# lot/ -A` tp-q7.e'!S�
State Certification/kegistration# I pn
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(f work is not commenced within six(6)'months, or if construction or work is suspended or abandoned for a period of sixp6,)months at any time after
work is commenced. I understand that separate permits must be securedfor Electricat Work, Plumbing, Sikns, Wells,Pools, urnaces, 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 hereb certify that I have read and examined this application'and know the same to be true and correct. Allprovisions of laws and ordinances governing this
typ e o7work will be complied v*J*whether s ecified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
ib
provisions of any otherfederal,state, or local 1paw regulating construction or the performance of construction.
Signature of OwnerrK,C'71AAL(?� Signature of Contractor
P I J_ f h,e, Print Name
nut Name 1Q)IC-71 ��e
S and subscribed before me Swo d subscribed before me
'WSOP�? Da�cf 12 this �Mcy of C)CTt� 2013
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Notary Public Notir-Y Public
Revised 0 1.26.10
A.M.ATMANU
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Local
Category/Subcategory Manufacturer Product Description Ilimitation of Use State
C.PANEL WALL
1.Siditig
2.Soffits
I EIFS
4.Storefronts
5.Curtam walls
6.Wall louvers
7.Glass block
8.Membrane
9.Greenhouse
10.Lynthehe stucco
11.Other
D.ROOFLNG PRODUCTS
1.Asphalt.shingles
2.Underlayments
I Roofing fasteners
4.Noustructural inetal roof
5.Built-up roofnig
6,Modified bittunen
�.-Sinsle ply roofing
8.Roofing tiles
9.RooLin
,E insulation
10.Waterproofing
11.wood sliiikglesishakes
12.Roofing slate
13.Liquid applied roofing
14.Cement-adb;;ive coats
15.Roof tile adhesive
16.Spray applied polyurethane
roof
at 12 :28 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10-00
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,O.ME-CVMPil1- improved: 10-16 1r,2S--29E
Levi deei;r1puon of Property"ing
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KNSO MICHELLE M
Owner J ST Atillilicaae IIFL32233
222 PINE
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Fee&mp�e Titleholder(if o"r tne"gwrier)-----—
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pncrie No. 904.7 PZ;4 ------- on@(1)year from 1he datO Of racording unless a
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