1520 FRANCIS AVE 15-ROOF-2083 CITY OF ATLANTIC BEACH
�Sl 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-2083
Job Type: ROOF PERMIT
Description: ROOF FL1012.41
Estimated Value: $8,500.00
Issue Date: 9/2/2015
Expiration Date: 2/29/2016
PROPERTY ADDRESS:
Address: 1520 FRANCIS AVE
RE Number: 172097-9005
PROPERTY OWNER:
Name: MOORE ET AL, CHELSEA & GLORIA, *
Address: 1520 FRANCIS AVE
GENERAL CONTRACTOR INFORMATION:
Name: DAVID MERRITT CONST. CO.(ROOF)
Address: 108 FLORIDA BLVD QA: MELISSA MICHELLE MERRITT
Phone: - -
FEES:
BUILDING PERMIT FEE $92.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $96.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC br:AL -t
• 800 Seminole Road, Atlantic Beach, FL 32233 -
Office (904) 247-5826 Fax (904) 247-5845 —
Job Address:
/59/- -R-crt en 0 Permit Number:
Legal Description - Qo Y F Piz* - #
oor a rea o , q. t. q. 't
Valuation of Work$ O� ° 'Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial t identi=.
If an existing structure,is a fire sprinkler syste igstalled? (Circle one): •es 0 N /A
Florida Product Approval # -- 10 /a- i I
products use roduc approva orm
For multiple pr p pin
Describe in detail the type of work to be performed: Q--e- ` '2< c
Property Owner boformation:
Name:2„ht; i A D47� Address: 1 307-0 n..c tic i S i4vp d
City _ ..4(v +i L 1( en (fi State i .Zip ...?-277 Phone c7 D(1, S . 'l `l 3..a___
Y 14 C-- c...l .e • ax l -k r , r e.ir
F,-Mail or Fax (Optional) u �• r•'
Contractor Information: _ VW a S 5 OA .-(2_fall—
Company Name: l t,Id AA Qualifying Agent:
Address: 0`l a--1 r-Vtrl I2d City a(„4.SUvoJI1i State t: ( Zip 3zZ.7�
-
Office Phone 1?TQ 3-06'7 Job Site/Contact isikimber 9 3.-/ (c)4 7 Fax#
State Certification/Registration#- CC C., 1 _, 41 i i -_
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 anceof is permit made to all r a permit e Domed o�meet the siandardr of as all laws indicated.
regulating onsstruction in this jurisdiiction. This permit becomes to nu l
issuance fw permit and that
all work within be �� suspended period
work isc commenced.not commenced undersand that sepa(6)-te permits must be secured for work Work, Plumbin abandoned a Wells,P of furnaces months at s,tHea ers,
ranks 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 EORDING YOUR NOTICE OF
COMMENCEMENT.
1 herebby certtfy that I have read and examined this Japplication and know the same to be true and correct. All provisions r f laws and ordinances governing this
provisions w k any other compiled,with whether Slawtfled herein construction. Tho granting performance permit does not o rresume to give authority to violate or cancel the
))412,i-O2L (-191-i&”
Signature of Owner et-- Att5"- --- Signature of Contractor
Name Print Name Ad 534 / u' le-al
Pant Nam t��:�,'��q.,..� �.�?,.,...�,-
Sworn to and subscri•ed before me Swor and subscri -d b ore me 1 5�
this, )Day of • W 20 this Day of . .,t.�.+J �0
_ / / ,.. -
N
Notary 'u• iJ ;�*� F C ~REYNOLDS ,o ,���:.4t NY SCOTT R�,r.,.r.�........4 .,ALfer tir
JEFFERY 017 RE OLDS 01.26.1.0
" r MY COMMISSIONFF180913 ,, MY COMMISSION' am r EXPIRES December 3,2018
F,,,,d° ExPORES December 3,2018 4,%;•,
(407)36e-oi53 Ftor100401rlrv5ervleernm (407)36ti-0153 FlorldatiOtaryServiCe.cOrn
/T "as\ zs :oz STOZ "T0 .des
AIM►. . Ila r4Ro N0.. , - �--- -
ComIVal
MO oodiNalpoll booklilibinern e t losoommoNoNIN M mob Nt owel i osepoople
WO dMISIONO 01 MME 50 r(P7 —7S 9
i1Nlrlf& p.. rrwi. u nt J'57 f-rl r L (s .1
• .L 3
•
sAWNlrYwdl•al Oft
1410 MO"Whialiwt Mena
---_.arwr it 1111 *rSi 2 '+ir. )it
err w1x V . z z.
t emerver sup 7 •
iA Na, '•'k 3 (01' 7 MUNrr
s db-E* •
PION NIL Not No.
. Now sol1+MMos.ro rmomo a1M•NwW s - . . otaoloonvoomma
r1Nmr11a -_- MNo.
•
NimmllpooNomalo Is Sim oFFINA . • WWI ur- -1 kw esomoromo vollpos solonorolow
ararmwaonwesmoot
NMI
• A
ma1+M..n writ de r pews 4r mobs Is~stele Mow%Nave a opirsidoid w
seam 1114111 PS Sorm4 FIN le se Ownrl s'
MOW
AMMO
BiliamililligIldradtiremsammitphiamilmilis dabII m.rnywr SIO&NrNwro> a
w .I
-•--"--• -'Ilerrwsrs--- i isv'`.---6-1 EiMir"-2ha3 9 1861. ..Y«r ..N,...,...././..�
Doc.10 20152(10920,OR BK 17287 Page � 4iT�1/�_ AiI fit/ —
Number Pages.1 ariwo.- - T
Recorded 09101)2015 at 09'.49 AM.
E�onnie Fussell CLERK CIRCUIT COURT DUVAL � �� •f�� N
COUNTY [ � �` �Z. ` i7 i8 RECUROING10.00 w O
Q i r
O
eo W
Z /Z •aovd cS : OZ STOZ 'TO "ds