1183 VIOLET ST - ROOFCITY 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 -1386
Job Type:
ROOF PERMIT
Description:
fl 1956.3
Estimated Value:
$6,950.00
Issue Date:
6/12/2015
Expiration Date:
12/9/2015
PROPERTY ADDRESS:
Address:
1183 VIOLET ST
RE Number:
171008-0000
PROPERTY OWNER:
Name: SOX, JAMES C
Address: 1116 N 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: ROMANO BROTHERS ROOFING, INC
Address: 1188 N 12TH ST OA DANIEL JOSEPH ROMANO
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FEES:
BUILDING PERMIT FEE $84.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $88.75
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:
Legal Description I'6- -- .]t C k4 'arceln
Flooraraiaot Sq.R. Valuation of Work $ to QS Proposed Work heated cooled e'la? nqon-heated/cooled_
Class of Work (chyle one): New Addition teration Repair Move .Demolition pool/spa window/door
Use of existinevinn'p� ed.stracture(s) (circle one):. Commercial idean'al 1
Tf so existing structure, m a fire a rmWer system Installed? (Circle one): Y� o N /A
Florida Product Approval #
For multiple products use. uct appform
Describe in detail the type of work to be
Office Phone( 1 " � U Job STW Contact Number rte»
State Cerdficati n/ReOsuation# rr 1-,1 Y q
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
WARNING TO
COMMENCEMENT Nb
TO YOUR PROPERTY
YOUR LENDER OR
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Signature of Owner ' "! Signn Tactor
Print NameE�0(`^II%5 L YA K Print Nanne nye--( Llc
Swom to and subsetthptbefore me M $WOm to and snbacQbed-before me on IS
AMBER L HICKS�"� "tn AMBER L HICKS Revised 01.26.10
MY COMMISSION MFF033216 j MY COMMISSION IFFWW a
E%PIKES Juy 2, 2011 1) FXMRESJ Iy 2,2017