297 AQUATIC DR - ROOF j r\,kjr
rj�'• �s J CITY OF ATLANTIC BEACH
;-- ,- . 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: 16-ROOF-612
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $1,960.00
Issue Date: 3/14/2016
Expiration Date: 9/10/2016
PROPERTY ADDRESS:
Address: 297 AQUATIC DR
RE Number: 177591-0000
GENERAL CONTRACTOR INFORMATION:
Name: JOHN GILMORE ROOFING. INC.
Address: 11647 GWYNFORD LN QA JOHN CHARLES GILMORE
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $59.80
Total Payments: $63.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC:: BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address:
261 7 ,4G1 yaw_ 1�J Permit Number:
Legal Description 3g-ZS- 7 Pr i 0/12 tstcs
g p 24E z l Oro Y r ,A- w�-351 b! Parcel #
Floor Area of Sq.Ft. "71 '32-7r-- r 7 t
Valuation of Work$ /9(, v' Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Re a Move Demolition pool/spa window/door
Use of existing/proposed structures)) (circle one): Comme ici al Residential
If an existing structure,is a fire spri c nkler s 'stem instafedTjx`cle one): Yes No N/A
Florida Product Approval # S3 /
For multiple products use product approva orm
Describe in detail the type of work to be performed: to c k 4/
e, rt-fir c r' d vr-r net si-i rtg
roue. rfpiac•e rd lien APP ri 10 Sor
Property Owner Information:
XName: 11•!x i s rvts r v-
53 6 D q S
Address: -T..
City Ni EPTt k to E B At-tt StateCLZip 31144 Phone y e �!-,2 cf G--3�o v
E-Mail or Fax#(Optional) b i I
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: NDhn t WIDYT *ding "'C Qualify}ing Agent: V1D ')41 V1 1111.O
Address: J()9 C0 "(p0 San Jos B t v�d-/ lye, City U Zc Csonai ik- State 'Z._ Zip Phone 96V- gg0 - gp ct Job Site/Contact Number p 3 22Z
y 955 -! 557 Fax ��p (4,80 !
State Certification/Registration# C LC 0S 7 6, -) c%
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 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 f 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 ElectricalWork, 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.
1 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 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.
/ /(ignature of Owner /
Signature of Contractor 4■„lai
'Tint Name g T LI V111-ZArv►s Print Name
3efo me Before e
1is 9tk Day of IniA-r(-h 20 t 6 this 14 Day of ant ,
fin �I °o"�Y P`A�'• CARLOS INFANTE
�-- �r :�* W'o TREBOR M.DEVERTER ��--' =: ��ae
lotaly Public I n'S Notary Public-State of Florida Notary Public , I s 1 is tat. , 'de
My Comm.Expires Mar 30,2018 0 y "��� os c My Comm.Expires F 0g 1, 7
71.1.1%',?i �� �, Commission Ar FF 107621 °��,°; Commission rY FF 041787
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