748 VECUNA RD - ROOF CITY OF ATLANTIC BEACH
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'" f 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2884
Job Type: ROOF PERMIT
Description: RE- ROOF - GARAGE ONLY
Estimated Value: $1,600.00
Issue Date: 12/14/2015
Expiration Date: 6/11/2016
PROPERTY ADDRESS:
Address: 748 VECUNA RD
RE Number: 171356-0000
PROPERTY OWNER:
Name: BEATY, ANNA M
Address: 748 VECUNA RD
GENERAL CONTRACTOR INFORMATION:
Name: DIBBLE ROOFING COMPANY
Address: 3518 MORROW ST QA JOHN R. DIBBLE
. Phone: - -
FEES:
BUILDING PERMIT FEE $58.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $62.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845 t5-Ro of_ ZBL-
Job Address: 1 L % V e&Rea_ ' act Permit Number:
Legal Description 31-DDI 3$-,S-o9 e Rata) Pa ns Unit-DA Parcel#
Floor Area'of Sq.Ft. Sq.Ft
Valuation of Work$ ',Lap,or) Proposed Work heated/cooled non-heated/cooled r 1
Class of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):, Commercial esldentta
If an existing structure,is a fire sprinkler system i st lle ?(Circle one): o N/A
Florida Product Approval# ;i i_•!inf21_4'v.:' P1 I ,i0.1 and _PI 14$e g
For multiple products use pro 1 uct approval form
Describe in detail the type of work to be performed: 0- pl Lf m {�.�1 b ft it r
Property Owner Information:
Name:el to P ALA Address:? 2 '' t•
City :.� _ a1 State�Zip?a33 Phone "(asmr1#'_
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: A a ' ....; la 0 ► Quali ing • lent:
Address: S iI I11 L�.. _ :•iV[': City _11E1 (' State ! Zip i7
Office Phone ^0 13 -- girh Job Site/Contact Number q(- "73(-- =35 Fax# •Or -133-OF S
State Certification/Registration# C Cc -- (-4s ii d y
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. 1 certify 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces,Boilers, Healers,
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.
1 hereby certify that 1 have read and examined this goplication 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. /
Signature of Owner GAN, , , Signature of Contractor v
Print Name .4 . Print Name 1l oh\ rbt -E
Sworn o and subs�e ibed bef e me Sworn o and subs gibed befcre me
this l� Day of Ui, ,e ,201 S this /4 Day of ye ,+ i i - ,201
9YY
ary blic ' MY COMMISSION#FFU937)0 otary 'ub IC / , °`
-;;� e •j MY COMMISSION#FFU93710
?o;�dr.' EXPIRES February 18.2018 '.! - ' 08.2018
(407)398.0153 FloridallotaryService.com (407)398-0153 FloridallotaryService.com