1227 VIOLET ROOF 2016 rLtl.1,Jv�
:� ' " `s J CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J =" 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: 16-ROOF-224
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $3,500.00
Issue Date: 1/28/2016
Expiration Date: 7/26/2016
PROPERTY ADDRESS:
Address: 1227 VIOLET ST
RE Number: 171009-0000
PROPERTY OWNER:
Name: HSBC BANK USA NA, hsbc
Address: 385 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: BUILDING UNLIMITED ROOFING & SOLAR
Address: 12620-3 BEACH BLVD# 181 JACKSONVILLE, FL 32246
Phone: 954-235-8307
FEES:
BUILDING PERMIT FEE $67.50
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $71.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: 22 7 Vi O to 4 5 f Permit Number:
Legal Description to-4 5- 9IV6,k I zi 3 SeG,'D_ 14 Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ � ,S017- 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/proosed structure(s)(circle one): Commercial Residential
If an existing structure, is a fire spriulder system installed?(Circle one): Yes Qo N/A
Florida Product Approval# FL 10/ Zq-P- 1(P rid rL 12S 12
For multiple products use protect approvalo-�rm—
Describe in detail the type of work to be performed: P2,04&w o /9-5 �01�lq' S X11 �iP
Property Owner Information:
Name: t2 eTt- lwo-e bfier5 Address: 0 0 t�) ���S 4A./ )ed
City -w e4� State!Z Zip 33403 Phone -7, 57 2O 3Z 71/ 3
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: .`. 1a.,..,, 1l n�L-,1��,4,,�� Qualifying Ag0.1 "7-,
Address: 2-3 S' 5�_jkv _ City Agent: State /::R_' -Zip
Office Phone !q5-q-?-35_9>30-7 Job Site/Contact Number Fax# !?bq 3717_ 83 7$
State Certification/Registration#
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 cert that no work or installation has commenced prior to the
issuance of a permit and that all work wtll be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 16)months at arty time after
work is commenced. I understand that separate permits must be secured for Elecxrica[Work, Plumbing,Signs, Wells,Pools,[urnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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 hereb cert that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinan governing this
type q work will be complied with whether s ted herein or not. The granting of a permit does n;presumeto give authority to ate or cancel the
provisions offany otherfederal,state, or lac aw regulating construction or the performance ofconstrucSignatur of Owner Signature of Con
Print Names v`'1...! i�•4-.............._............ Print Name x --.........Y` - .............. `' . __. _...........
Sworn to and subsc bed before me Sworn to and subscribed before me
this V2 Day of t ,20 i b this ay of l`!• 201
11LCMW A.K add
a, NOTARY PM IC
Alwi ChrbgA-Madid otary Public NOTARYPM �c otary a is STATEOFF10FtIQA
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