1365 & 1369 ROSE ST - ROOF PERMIT , '0
, 01j y�,�„�.
z. �s, CITY OF ATLANTIC BEACH
10
r' ,''. -;;A, 800 SEMINOLE ROAD
u z: 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-1842
Job Type: ROOF PERMIT
Description: RE ROOF- SHINGLES
Estimated Value: $7.176.00
Issue Date: 7/30/2015
Expiration Date: 1/26/2016
PROPERTY ADDRESS:
Address: 1365 ROSE ST
RE Number: 171064-0110
PROPERTY OWNER:
Name: SOVEREIGN INVESTMENT GROUP LLC. *
Address: 2728 DAVIE BLVD SUITE 134
GENERAL CONTRACTOR INFORMATION:
Name: D & S ROOFING OF N. FL, INC.
Address: PO BOX 1986 QA RANDALL SCOTT DRAWDY
Phone: - - _
FEES:
BUILDING PERMIT FEE $85.88
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $89.88
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
• 800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 15- O O c--/ S47
Job Address: 1.3,a 5 '4' 13 0 V.OSE, `-:: 7 Permit Number:
St c t--( A T..F1tir;.C. ai:C Ctk S 25+ ' Lox- 2� l " Cj 1lU
Legal Description Lo T 3 3L� 23S Parcel# (. 1 CAL
Floor Area of Sq.Ft. 'q.Ft
Valuation of Work$ -7, (I �„ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration d;.-pair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one):• Commercial 9 /A
If an existing structure,is a fire spnnlder system • tailed?(Circle one): es No ,- _ �
Florida Product Approval# FL i C�g~t`t. • ( J 15 Ft FE'LT �L.. L1064 2
For multiple products use product approval rm •
Describe in detail the type of work to be performed: Q�t7.4,0s= S 4:s.t& " TC ifu..i_'jL 3, 30 S jt,nz+ S j
5/i2 p;Tc
Property Owner Information:
• Name: Address:
City State_Zip Phone
E-Mail or Fax#(Optional)
Contractor Information:
Companyr�Tame: )*S i� 6 r (l�bcnt ���i0 4 -'.Qualifying Agent: S c � w1.Li
Address: 1 O >O'& 6`' City C -AN D4� State 9L Zip 3'2o 7
Office Phone c'l `ti- -tc.-cnJ Job Site/Contact Number 904.2�.t j -0245 Fax# C)`t- 2"16.01 v
State Certification/Registration# C.CC-- kl 2. C'Su
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 certfr 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��ix f6 month at any time et after
work is commenced I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, WW t u
Tanks and Alr 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 here certfy that I have read and examined this placation 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 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 construction or the performance of construction.
41/2—
Signature of Owner glair' Signature of Contractor
Rp►DL ,S co�T Q�w 1J�
Print Name Letan DOCUme1l l�n................ Print Name
Sworn to and subscribed before me Sworn to and subsced before me 20(�
thi _ )Sc Day o a—(7 0/C-
... this V_Day of UL(J`
I . C.
otary Public GAIL HARRISON Not ' iii ft,T.Commission Number 196416 43‘;....."1,a NANCY D.CORLEY
Revised 01.26.10
• • My Commission Expires * ;:(_� * MY COMMISSION t FF 026178
May 14, 2016 i EXPIRES:July 31,2017
— ---- sr4/FoF,li eO! Bonded TAru Budget Notary Services .