899 Atlantic Blvd 2014 Roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
14-00001321 Date 8/15/14
Application Number � � g99 ATLANTIC BLVD
Property Address . . • •
Application type description ROOF PERMIT
Property Zoning . . . . . . . COM GENERAL DISTRICT
Application valuation . . . . 29000
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Application desc
NEW ROOF PANERA
---------------------------
Contractor
Owner
_ _ _ ------------------------
EQUITY ONE ATLANTIC VILLAGE SUPERIOR BUILDING INC
11497 W COLUMBIA PARK DR
1600 NE MIAMI GARDENS DR STE 3-4
ATTN:TREASURY DEPT JACKSONVILLE FL 32258
MIAMI BEACH FL 33179
---------
Permit
. ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 195 . 00 Valuation . 29000
Issue Date . . •
Expiration Date . . 2/11/15
2 . 93
Other Fees • STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 , 93
________ ---
_ ------------
Due
Fee summary Charged
Paid--- Credited
00 . 00
Permit Fee Total 195 : 0000 195 . 0000 00 . 00
Plan Check Total 5 86 00 . 00
Other Fee Total 5 . 86 00 . 00
Grand Total 200 . 86 200 . 86
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
Permit Number:
Job Address: �C� � y v'
Legal Description Qarcel # '
F oor rea o q. t. �q.rt
Valuation of Work $ q Proposed Work heated/cooled
non-heated/cooled
Class of Work(circle one): New Addition Alterati Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commer ' 1 Residential
If an existing structure,is a fire si
-sprinkler system nsta a ircle one): Yes No N/A
Florida Product Approval # k
For multiple products use proc approva Corm 1 CI I—10C C-t—
Describe in detail the type of work to be performed: �����/ t ^ I
Property Owner Informa ' 7
Name: Address:
City Zip Phone
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: L Qualifyin Agent: Zi
City State El/ P
Address: Fax# q''b�l- 13-ot1
Office Phone gbN - ��i lJ1 -N 1 Job Site/Contact Numberg�H-5�5-9�(Q
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
n has commenced
that no work
r installatio
'spplicatin is hereby
r b amade to nd that obtainll will bethe
iperformed toomeet rk he standardssof all las aws regulatincated. I g construction inothiis jurisdiction. months This permit becomesrior onull
and inwor k is menced.ot commenced/understandwhat separate permits must be secured for Electrical Work, Plumbing, Sigconstruction or work is su ended or ns,aWellseri�P olsxt�u�naces, Boiletyst�He Heaters,
'or is'I
k
Tanks and Air Conditioners,etc.
WARNING TO OWNER: O N YOUR PAYING TWICEARDA NOTICE OF
OR IMPROVEMENTS
COMMENCEMENT MAY RESULT
TO YOUR PROPERTY. IF YOU INTEND RNEYgEOOOBTRE CORDING YOAIN UR NNOTICE OF H
YOUR LENDER OR AN ATT
COMMENCEMENT.
' l hereb certify that/have read and examined this a plication an not.
The sranting of a peme to be true a dcesnd cnot. Aplresumet�go el authority tos and ynqnces violateorcancel this
e
type of work will be complied with whether speei led herein or g
provisions of any other federal,state, or, 1 law regulating co truction or the performance of construction.
t Signature of Contractor
Signature of Owner_ --- —
Print Name
.. .. . .. .. ............................ .
� P Print Name 1....1....I.I..vM 1 ........U�.►Yl/I....................................
Sworn to and subscr' ed be o e
Sworn to and subscrib d before m 20
4Notary
Day of 20 , this Day f
RI V
Nota NOTARY PUBLIC
blic NOTARY PUB C STATE OF FLOR A .
STATE OF FLORIDAComrnFFevlsed 01.26.10
Commit FFO"588 Expires 8111/2017
1 Expires 8/11/2017