645 Plaza ROOF ��" \S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
\J ;", ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
\f_.)JilS- r'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
7OB INFORMATION:
Job ID: 15-ROOF-1604
Job Type: ROOF PERMIT
Description: Metal Roof over Existing
Estimated Value: $4,000.00
Issue Date: 7/6/2015
Expiration Date: 1/2/2016
PROPERTY ADDRESS:
Address: 645 Plaza
RE Number: 171218-0000
PROPERTY OWNER:
Name: CROSSMAN, DIANNA N
Address: 645 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: THE ROOF DUCK WATERTIGHT ROOFING SYSTEMS
Address: 6095 Shadehill RD
Phone: - -
FEES:
BUILDING PERMIT FEE $70.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $74.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: 645 PLAZA Permit Number:
Legal Description 30-60 17-2S-29E Parcel # I7283-0020
I..loor Area of Sq.l•t. sa.Ft
Valuation of Work$ 4000 Proposed Work heated/cooled 1574 non-heated/cooled 644
Class of Work(circle one): XNew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structu ' le one): Commercial Residential
If an existing structure,is fire sprin der s m installed? (Circle one): Yes No N/A
Florida Product Approv FL11651.17
For multiple products se pro m
Describe in detail the type of work to e bulged: METAL ROOFING OVER EXISTING SHINGLES
Property Owner Information:
Name: MICROBIAL NATURAL PRODUCTS Address: 1207 SEMINOLE ROAD
City ATLANTIC BEACH StateFL Zip 32233 Phone 904-654-4244
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: The Roof Duck Watertight Roofing Syst Qualifying Agent: Cord Poe
Address: 3948 3rd Street South Unit 195 City Jacksonville Beach State FL Zip 32250
Office Phone 904-345-0663 Job Site/Contact Number 904-345-0663 Fax#
State Certification/Registration# CCC1330589
Architect Name&Phone#
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and,etddress
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 lairs 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 aperiod of six(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, Boilers, Healers,
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 Ok AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that l have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governin this
type of work will be complied with whether specified herein or not. The granti r
ng of a permit does not presume to give authority to violate or cancel the
provisions of(anyy other federal,state,or local law regulating construction or the performance of construction.
"""' Q+tY1tr
Signature o Signature of C aetor tAila)
Print Name ,
C�� ( J"�^ Print Name
Sworn and subscri.-d before me Sworn o and subscrjJiged before me ,20
this / Day of ,2015 this Day of . k l L
otary 'u.t i • - • • L KORN 1Tqot• c '1h; .- � �'� L •RN••'• M"COMMISSION u FF224712 `---4.i', • MV COMMISSION I FF224712
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