345 4th St - Reroof , , ! CITY OF ATLANTIC BEACH
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4 ) 800 SEMINOLE ROAD
'J' _ ;" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Jj319
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ROOF -284
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $9,000.00
Issue Date: 2/5/2016
Expiration Date: 8/3/2016
PROPERTY ADDRESS:
Address: 345 4TH ST
RE Number: 169837 -0000
PROPERTY OWNER:
Name: MCCAWLEY, PETER V & INGRID D, *
Address: 320 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FLINT CONSTRUCTION SVCS (ROOF)
Address: 1419 LINKSIDE DR QA RUSSELL MARK FLINT
Phone: - -
FEES:
BUILDING PERMIT FEE $95.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
P
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: ? 4. 4 1- - 7e6 ' a
Permit Number:
Legal Description
Floor Area of Sq.Ft. Parcel #
Valuation of Work $ r Proposed Work heated /cooled t
non - heated /cooled
Class of Work (circle one): New Addition A era
Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) circle one): Commercial R
If an existing structure, is a fire sprinkler system installed? (Circle one): lam N /A
Florida Product Approval # FL - _5'4.4 C(
For multiple products use product approval form
Describe in detail the type of work to be performed:
s %;74 4' -
Property Owner Information:
} M / Name: Y v ` 1 (t l C A �1/ � '. 3y e.
+ A
Address: 3 '4 5.
Cit 1 , 4 Gr, 4L A State Zi 322 33 Phone 6104 - l —o L o s
E -Mail or Fax # (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: 1 44
Company Name: 17; 41 COA.s fil') clo 1 Cec.te-e Quaking Agent: Jul/ f (;-t f
Address: / f (7 erSf . ti1/4
Office Phone q ( 7 4 (p � City S� X State F� Zip ? aJ.
9 Job Site/ Contact Number ' 9 969 Ce Fax # 7,2 poi(
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
issuance
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 hat all and void f wok is co iced within six performed 6) months, meet the
construction or o work is suspended ended or abandone i d for ahpejurisdiction.
iod of six n 6) months at any time after
any is commenced. I understand that separate permits must be secured for Electrical Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
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.
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
!ype 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
7rovisions of any other federal, state, or local law regulating construction or the performance of construction.
C.
>ignature of Owner a =� w e Signature of Contractor � Z•� — ,,��
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'I int Name Y , 0 jJt CC C. e w( 4 y Print Name 4-rise e ! ( JP-171
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