1073 ATLANTIC BLVD ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-1128
Job Type: ROOF PERMIT
Description: REROOF FL14210.3
Estimated Value: $17,000.00
Issue Date: 5/12/2015
Expiration Date: 11/8/2015
PROPERTY ADDRESS:
Address: 1073 ATLANTIC BLVD
RE Number: 177496-0000
PROPERTY OWNER:
Name: ATLANTIC BEACH MINI STORGE INC
Address: 7880 GATE PKWY SUITE 300
GENE RAL CONTRACTOR INFORMATION:
Name: FAST COAST SYSTEMS
Address: P O BOX 396 CIA EVERETT FRANK CHRISTIAN
Phone: -
FEES:
BUILDING PERMIT FEE $135.00
STATE DCA SURCHARGE $2.03
STATE DBPR SURCHARGE $2.03
Total Payments: $139.06
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL COPY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1073 Atlantic Beseh Blvd Atlantic Beach Fl,32233 Permit Number:
Legal Description 38-25-29E Parcel# 177496-0000
Valuation of Work$ /7� d D 0 oar o q. t. q. [
Pro osed Work heated/cooled non-heated/cooled
�°
Class of Work(cycle one): New Additio¢ Alteratio¢ - Repair Move Demolition pooVspa window/door
Use of exisdng/pr=wd structurex circle one): tal Residential
If an existing struccltuure,is a fire sp ' er system Inst a one): Yes No N/A
Florida Product Approval# FL#14210.3
For multiple products use product approval form
Describe in detail the type of work to be performed:Re-Roofing_
Prooerty Owner li formatiou:
Name: Atlantic Beach Midi Storage Inc Address: 7880 Gate Park Way
City Jacksonville_State FL_Zip 32256—Phone 904992-9000
E-Mail or Fax#(Optional)_
Contractor Information:
Company Name: East Coast System,htc Qualifying Agent:Everett Frank Christian
Address:P.O Box 396 City Stark State FL_Zip 32091_
Office Phone 904-368-0017 Job SiteJ Contact Number_904-591-9521 Fax#904368-0019
State Certification(Registration#CCC056399
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 insmlladom as indicated. /cert that no work or iwm/latim has commenced prior to th
issuance, ape. mit and that all work will be performed m meet the standards ofa/l laws regulatingmwaiietion in thu jurisdiction. Thispermit becomes nul
and void t work is not commenced within sir(6 months,or ifconstmction or work u suspendedar abandoned fora enod ofsix/6)months at any time ale,
work is commenced. l understood that sepamte permits mast be secured for EltmicaC Work,Plumbing,Signs, IiPelis,Pools,Famaces,BoAers,Healers
TanksandAhr Conditioner,,eta
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 Y&W NOTICE OF
COMMENCEMENT.
/hereby cert thmlM1ow eod arm anon' ed th' plicatia krmw the samerobe true andcorrect. A/lprovisiortr of/aws and ordinances governing thi.
type of work will be complied with wh ed he nor not The granting of a permit does not presume to g,ve authority to violate or cancel th,
pmvisiomofanyotherfedernt,stme, regu/a gconstmctlon ortheperformance ofmretruetion.
Signature of Owner Signature of Contractor
Print Name -...... .....� —.-- PrntNameLi.N..'L.._C_�-�/CSs1�9�.._.........
r�ax1._?'4._....__........ ....
Sworn to and subscn before me to subscri fore me -�
thisDay of:6-J4 .20 �� 's of 20
Notary Public a�,," os' NdiowfiLla mF sea
, n'atr:. IIYWMaSSlOar18193 +F Shirley L Graham
{` � � my camrmaon FF 0seaa0 Revised 01.26.10
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