2307 BEACHCOMBER TRL ROOF S
`sem CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
U ' 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-1858
Job Type: ROOF PERMIT
Description: Re Roof - Shingles
Estimated Value: $14,980.00
Issue Date: 7/31/2015
Expiration Date: 1/27/2016
PROPERTY ADDRESS:
Address: 2307 BEACHCOMBER TR
RE Number: 169463-0156
PROPERTY OWNER:
Name: ROBERTS, DUANE AND CAROL,
Address: 2307 BEACHCOMBER TR
NERAL CONTRACTOR INFORMATION:
Name: A J WELLS ROOFING
Address: 5432 WELLER PL ARTHUR J WELLS JR
Phone: - -
FEES:
BUILDING PERMIT FEE $124.90
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $128.90
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845 S — iR 00-f_ I S's
Job Address: cN caMAiE R T#,Ar*k. q g 5223; permit Number: '
Legal Description qL-I - ocEAA%0A� „,,;-+ � Parcel# l69 6
Valuation of Work$ I oor Area o q. " t
�, �._ Proposed Work heated/cooled -1 non-heated/cooledL�
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existin ropo
If an existing�pructu e,s a fire sprinklefl�iresystele m installed?(Circle one): �Vue
Florida Product Appproval# - �,4. �,
For multiple products use pr uct approva form
�'�� ` sK��`� � FL l 3 Y 2
Describe in detail the type of work to be performed: RE.
Property Owner Information:
Name: tvi1,-►<y t„�%1t
Address: 23, l
City- AT,..A T;4 E&tsc,4 State—Ft Zip 314M Phone_ 9,nt. sY3
E-Mail or Fax#(Optional)
Contractor Information•
Company Name: A•'3 �tPl\< �ot-.y c�..s�rr..•�w.+
Address:
Qualifying Agent: ... �„�
City ?w�1,s..-.n'I I �r!
Office Phone goy. 5 S'3 0064 Job Site/Contact Number State f?—
State
?- Zip 32a_ 1_i
State Certification/Registration# t cc. 1 y __ 9•Y• !pS SLBk Fax# p0 55l ..Otj�
Architect Name&Phone# 87
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 wo ork and installations as indicated. 1 certify that no work or installation has commenced prior to the
and void work islnat co raced withinlsrz(�}monthst or if co�ruction or nark is suspee d o abandoned for ahpleriod js ()Tmorr hs at an come a i lr
work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plunebing,Signs, Wells,Poo/s,�urnaces,Boilerys,Head s,
Tanks and Air Contditioners,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.
1 here certify thou 1 have read and examined this plication oru/know the same to be true and correct. Rll provisio»s of laws and ordinances governing this
type owork will be complied with whether speci red herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provrsrons of any other jeder 1,state, or local law gulah'n construction or the performance ojconstruction.
Signature of Owne
Signature of Contra
Print Name Print Name
Sworn_to and subsc ' re me
this Day of d, 20 �� S i o o and subscribed before me
thi Day of 20
Notary Public
wot
Notary Public State of Florida
26.10
Kimberly Baker =d;
Public State of FloridaMy Commission FF 012533 ly BakerExpires 04/28/2017mission FF012533
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07/31/2015 at 11 :08 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAIL COUNTY
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