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1965 W SEVILLA BLVD - RE ROOF � �.!'L J ' sl CITY OF ATLANTIC BEACH 1 s) 800 SEMINOLE ROAD . Z. ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ' J;1!>� ROOF PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ROOF-2534 Job Type: ROOF PERMIT Description: RE-ROOF - SHINGLES Estimated Value: $12,000.00 Issue Date: 10/27/2015 Expiration Date: 4/24/2016 PROPERTY ADDRESS: Address: 1965 W SEVILLA BLVD RE Number: 169462-0365 PROPERTY OWNER: Name: BRODEUR, TRUST Address: 1965 SEVILLA BLVD GENERAL CONTRACTOR INFORMATION: Name: CENTURY CONSTRUCTION INC Address: 509 PORPOISE POINT DR QA ALBERT LEWIS ROGERS Phone: - - FEES: BUILDING PERMIT FEE $110.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $114.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r• . BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 \ Office (904)247-5826 Fax (904)247-5845 15-R©OV Z53 4- JobAddress:l 5 /C1`& tid 11.kn'b'C h `L Permit Number: Legal Description 5 1-V ' 2$x-- $ A liA s .., -1-2 Parcel# Valuation of Work$ 1d■GC,O ' oor ' ea o q. t. Proposed Work heated/cooled no.n-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) circle one): Commercial esidential , If an existing structure,is a fire sprin r syst inst Iled?(Circle one): Yes No N/A Florida Product Approval# / /p7 `7/101. t For multiple products use product appro a orm Describe in detail the type of work to be performed: -12.t.-7800 f' Property Owner Information: Name: (�P,r1 � Address: ig6 5 Sev; l� L v)City b\ y,L1c 2,1, State 1'- Z E-Mail or Fax#(Optional) l ip 3.)233 Phone Contractor Information: CONTRACTOR EMAIL ADDRESS: l_SL". v L,, Company Na :,b,r Cn5 rue b t r 1 3.-1771.. Qualifying gent: Address: Q/5 Clue �, 7' - rid Office Phone City �J�• 15uS AA— State rL Zip 3ac��pCe State Certification/Registration# Job Site/Contact Number Fax# 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 certfn,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 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. r 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 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type ofwork 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. Signature of Owner aa.„.u; a_ o Signature of Contractor "z.,---- Print Name fl u p t e- NR a r C d v 4/1w.-Y 6Print Name Reae.4-5 Before me his _Day of 0�-o-� 20�� Before,�ne ..i2 '``'� — 3— this au Day of ,205 Public Aug,' Notary Pudic stag.w Florida A4/4..c...... ( / Notary Pudic$�y�d Florid Jennifer Lee Gsell-Daniels Public Jennifer Lee Gsell_Daniels • My Commissjo,FF 144530 My Commission FF 144530 14 ,wd Expires 07/23/2018 - , . . 1 a1(�R3J2018•