1241 Ocean Blvd 2014 Roof CITY OF ATLANTIC BEACH
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�J 800 SEMINOLE ROAD
r ATLANTIC BEACH,FL 32233
J $ v ROOF PERMIT INSPECTION PHONE LINE 247-5814
'P/ r ALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
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Job Type: ROOF PERMIT
Description: REROOF METAL
Estimated Value: $40,000.00
Issue Date: 10/15/2014
Expiration Date: 4/13/2015
PROPERTY ADDRESS:
Address: 1241 OCEAN BLVD
RE Number: 171829-0000
PROPERTY OWNER:
Name: EZELIUS, PER OLOF
Address: 356 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: TOWNSEND ROOFING &
Address:
Phone: - -
FEES:
BUILDING PERMIT FEE $250.00
STATE DCA SURCHARGE $3.75
STATE DBPR SURCHARGE $3.75
Total Payments: $257.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 1 7O C e a v-, (k` Permit Number:
Lit S 6 11130
Legal Description 5-2-9 F MA44iI-Z, 6�,r 115 Parcel# ` 7 18 2_1 - D 00 6
vv Floor Area q. t. Sq. t
Valuation of Work$ n�0� ' Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): �e ) Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial q -I
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval # F-� L 5 7,1 I • 3
For multiple products use product approval form
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Describe in detail the type of work to be performed:
M� coo f ►tjS sI �S1 ,c_k Uh4,'Ia , ��� HT
Property Owner Information:
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Name: NlU-Irn T Address: L �J �✓! lei �-I�
City P1,4� • State lr[- Zip."s 2,2 Phone Q c��
E-Mail or Fax#(Optional)
Contractor Information: I �" `�
Company Name:/WO►cod RLO�11\ �t{,`�`S Kc�+�r/l �[�NC�Si��Quali ing Agent: �h�" Cwt t1j
Address: INN New ?u n !-(• (1 S -Citya�l sc��i%(1�— State_L Zip '3 7—Z z
Office Phone 10-05--_595-7 Job Site/Contact Number ari S Lt7Z_-gg7`i Fax# 110q-t ys—S V yz
State Certification/Registration# GCC 1-4 Z t Z_'91
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 cert that no work or installation has commenced prior to the
issuance of a permit and that all work wt11 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 sex(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, Boileh, Heaters,
Tanks and Air Contfitioners,etG
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 I have read and examined thisplication and know the same to be true and correct. All provisions of I ordinances governing this
type o1 work will be complied with whethe sect ted herein or not. The granting of a permit does not presume to gt ori to violate or cancel the
provisions of any other federal, tate, or loco aw re 1 ing const tion or the performance of construction.
Signature of Own Signature of Contracto
Print Name -/ 1� /'%�7 Print Name cin SeK�(
/......l._......... ' .. . ------..--------........_...._.... ..................................... -...._........... ----------- -------------...................................................................
Sworn to and bscribed before me Sworn to and subs
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this_� D of �r 20 this y of �. MbMfbti�t
Notary'Public o1raY°°er. CHRISTOWNSEND Nckfaf FARKi-c
MY COMMISSION#FF 092654
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EXPIRES:March 25,2018
Jt�l6OFFV-pP4' Bonded Thru Budget Notary Services