1525 FRANCIS AVE - ROOF �. , v ; `s' CITY OF ATLANTIC BEACH
,, 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'�);t
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
308 INFORMATION:
Job ID: 15-ROOF-1605
Job Type: ROOF PERMIT
Description: metal roof over shingles
Estimated Value: $2.000.00
Issue Date: 7/6/2015
Expiration Date: 1/2/2016
PROPERTY ADDRESS:
Address: 1525 FRANCIS AVE
RE Number: 172283-0020
PROPERTY OWNER:
Name: LYLES, TOMMY & SHIRLEY, *
Address: 13925 HUNTERWOOD RD
GENERAL CONTRACTOR INFORMATION:
Name: THE ROOF DUCK WATERTIGHT ROOFING SYSTEMS
Address: 6095 Shadehill RD
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $60.00
Total Payments: $64.00
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: 1525 FRANCIS AVENUE Permit Number:
Legal Description 26-50 17-2S-29E Parcel # 172283-0020
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S 2000 Proposed Work heated/cooled 768 non-heated/cooled 98
Class of Work(circle one): XNew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed struct one): Commercial Residential
If an existing structure,is re sprin cler system installed? (Circle one): Yes No N /A
Florida Product Approv # _ FL10452 •.'
For multiple products u ee product appr YaI-form
c
Describe in detail the type of—work to be performed: METAL ROOF OVER SHINGLES
Property Owner Information:
Name: KOSTOKAS INFORMATION SYSTEMS Address: 1525 FRANCIS AVE
City ATLANTIC BEACH State Zip 32233 Phone 904-535-3071
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 lob 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 Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and instIlations as indicated /certifi:that no work or installation has commenced prior to the
issuance ofa 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 raid if work is not commenced within six(61 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 for 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 a plicatiou and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specs red 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 construction or the performance of construction.
Signature of Owner _ ,,,, Z-0.--1.- -)70--4---" Signature of Contract
Print Name (470„,,A \'<.t.,„V:. k`t ...................._..._.._..._.....__...._. Print Name ^ ?c16—
Swo and subscribed before me Sworn • and subscri• d before me
this Day of *at/ �' , 20)�y this day of 'r; ,201`5
o ' Public. . ,,.,
.,:r*-. ' CARINA L KORN ARMIA
'' ': MY COMMISSION*FF224712 ;�,.c '..: L KORN
MY COMMISSION*Rey}st! 1.26.I 0
EXPIRES Apr9 27.2019 EXPIRES April 27,2019
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