346 Sargo rd 2015 roof �J It \ CITY OF ATLANTIC BEACH
' ) 800 SEMINOLE ROAD
J ` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�Jill�r
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-93
Job Type: ROOF PERMIT
Description: fl 10124.1
Estimated Value: $8,500.00
Issue Date: 1/14/2015
Expiration Date: 7/13/2015
PROPERTY ADDRESS:
Address: 346 SARGO RD
RE Number: 171686-0000
PROPERTY OWNER:
Name: ROOS, EUGENE A
Address: 346 SARGO RD
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone: - -
FEES:
BUILDING PERMIT FEE $92.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $96.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
jP BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-58.26 Fax (904) 247-5845
Job Address: l Perit Number:
Legal Description SS'ZS'Za ( C Parciel son
%,
oor Area of Sq.1t. t
Valuation of Work S Proposed Work heated/cooled non- heated/cooled
Class of Work(circle one): New Addition Alteration epai Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/
Florida Product Approval# 1m TA - f!to
For multiple products use product approval form
1ZPro1!2Describe in detail the type of work to be performed:_'ZQ,Q K j� (Q 11.2—
Property
perty Owner Information•
Namet Q Address: . (0 scu q
City_Rtui► he bcCI(' S_tate_F[_,Zin '�iZ hone
E-Mail or Fax#(Optional) 1
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name Qualifying Agent: Jv�S 5��
Address: City State Zip 22
Office Phone Job Site/Contact Number
State Certification/Registration# k�izclUCl,
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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured or 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 I have read and examined this application 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 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 constructs or the performance of construction.
Signature of Owne Signature of Contractor
Print Nameq�.. .................... .....Q. 5..... Print Name G�y1.. ............_�.. ....
�.r....... .. S � h.:�...e.....1 ......................................
Before e
Befor e
t l Day of J a this Day of S
,•'�� �e'% WAY RID
: Notary Public-State of Florida - • `° tary Public-State of Florida
Notary Publi 017 Nota Public Jun 20,2017
�'.,',Fo;:•' Commission # FF 29966 ''o'e �o%:', mission# FF 29966
isu a-V 172 671
Doc # 2015008894, OR BK 17033 Page 1645, Number Pages: 1, Recorded
01/13/2015 at 04 :00 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
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