91 Donner Rd Roof 2014 ai r�'�f r1t�
s f CITY OF ATLANTIC BEACH
1 s) 800 SEMINOLE ROAD
J u ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000381 Date 3/13/14
Property Address . . . . . . 91 DONNER RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8400
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Application desc
fl 10124 . 16
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Owner Contractor
-
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IH3 PROPERTY FLORIDA GREAT WHITE CONSTRUCTION INC
5909 HAMPTON OAKS PKWY 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 322334208 JACKSONVILLE FL 32216
(904) 237-1268 (904) 838-1659
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 8400
Expiration Date . . 9/09/14
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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 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 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: Permit Number:
Legal Description 0 Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ Proposed 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 enti
If an existing structure,is a fir �rin er system installed? (Circle one). Yes N/A
Florida Product Approval# to
For multiple products use product approva orm
Describe in detail the type of work to be performed: r t b f , 30 S U , sl �-
Property Owner Information:
Name: or —Address: Wcl f46LMPb)h OAS PK41lnl
City Yn C tate E/-Zip 3 301 U Phone q I�Ca
E-Mail or Fax# Optional)
Contractor Information: —� cI
Company ame: " Qualifying gent: I(ay1s � h
Address: Ci L State Zip
Office Phone Job Site/ ontact Number ax# - -Me'
State Certification/Registration#
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. 1 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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of s:z(6)months at any time after
work is commenced. I in
that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces,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 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type oo work will be complied with whether speci ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor S,A5_ —
Print Name L. / .fmh......Sh�(.lYj�?C................................................... Print Name --.Tr
�...�. .
f L.r..U4.�n. ....................1 .... . . . r...................... ..
Sworn to a ]
and subscribe efor me Swo o and subscrib before me
this Day of ar is Day of 214
ASHLEY RIDGEWAY Pb
'
1 Florida ' 4 tj
Notary Public ota Public • * - 0►`{ ubtic-State o rida
My Contra.Expires Jun 20,2017 •. Rw 2017
Commission#FF 29966 �oP. My Cc.r;.•Ex fres Jun
Doc # 2014054351, OR BK 16714 Page 2414, Number Pages: 1, Recorded
03/11/2014 at 03:40 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
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