342 SKATE RD FLOOD REPAIRS � r �f,
' , - v , _ , , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
t ATLANTIC BEACH, FL 32233
_ ._______ ) INSPECTION PHONE LINE 247 -5814
RESIDENTIAL ALT /OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -RAAR -683
Job Type: RESIDENTIAL ALTERATION
Description: FLOOD DAMAGE REPAIRS
Estimated Value:
Issue Date: 3/21/2016
Expiration Date: 9/17/2016
PROPERTY ADDRESS:
Address: 342 SKATE RD
RE Number: 171661 -0000
PROPERTY OWNER:
Name: LOVE, TRUST
Address: 342 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: ARMSTRONG CONSTRUCTION
Address: P.O. BOX 5700 QA SHANNON PAUL ARMSTRONG
Phone: - -
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
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 O n
800 Seminole Road, Atlantic Beach, FL 32233 Cf' - ( p V
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 34 Z S) okt, Rd Afita,, „-bC, Ke,a � FL 322 Permit Number:
Legal Description LC \ 1 Parcel #
V, ps r a of Sq.F't. S .Ft
Valuation of Work $ ! $) 0 Proposed Work heated /cooled n heated /cooled
i
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial Residentia
If an existing structure, is a fire sprinkler system installed? (Circle one): es No N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: A,ry'9 r *Uhl*, I V1 S ( 1- 4 o (4.cdaitl6,'I'Nk
Property Owner Information:
Name: / , - I Address: 3y 9 k t ,
City 1., State ' Zip Phone 9OL/ — (.9 711 7
E -Mail or Fax # (Optional) — b )1
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company ame: IL u _it .. 13 . . Qualifying Agent: Shahriy )rfl7S
Address: KO, ' • n7 8
[ )C City State �►,!! !0 Zip ��irr
Office Phone l',c — .,,g — Job Site/ Contact Number j4 l Fax # % 01-/ - p '1 ')
State Certification/Registration # t r, e is C }lO a_
Architect Name & Phone #
Engineer's Name & Phone # 1111 ���;v,Ln'
Fee Simple Title Holder Name and Address 1; _1”"
Bonding Company Name and Address 11111
Mortgage Lender Name and Address 11111 ► � 11111
Application is hereby made to obtain a permit to do the work and installations as indicated. I c ;rte t . - . • • • • • • • � . enced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regula, ng construction in this furls, is ion. This • ermit becomes null
and void if work is not commenced within six (6) months, or if construction or work is sus ende• or abandoned for a •eriod of six 6) mon -' s at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, ' , . ' : , . ' .. , , , , 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,Oti
COMMENCEMENT.
I hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of la , and or' in• •'s governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to gzv- a hor to i. • or cancel the
7rovisions of any other federal, state, or local law regulating construction or the performance of construction.
>ignature of Owner'..-----"4.$E
/� Signature of Contract. / .'
'rint Name lertivi \o IVY F'.►..l..l..f.� Print Name 5.h��.oY. , 5 I .
lefore e 6 Befor pie
its i-9 1 Day of �It r�� , 20 1 l4 this t/J ► of / . 4 —
AMl WIAROADONNA Al / ` t i ii.; • MYCOA1hM 81400 1
rotary Public -- f EXPIRES: September 1 18 Notary P II I -' �: Bo do Th p und,;romiers
Scowled Thou n
,_ _ . —_- ' evised 01.26.10
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