1971 MIPAULA CT - ROOF CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
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OWNER OF PROPERTY D n
TELEPHONE: �S�1
CONTRACTOR: ARLINGTON BEACHES ROOFING, INC.
CONTRACTOR'S ADDRESS 1 441 CESERY TERRACE
JACKSONVILLE, FLORIDA
zip 32211
STATE LICENSE NUMBER: RC 0023962
TELEPHONE:744-8888
DESCRIBE WORK TO BE PERFORMED R — OOF:
VALUATION OF PROPOSED CONSTRUCTION ,j$9C C
MATERIALS TO BE USED. 3 31-1
SIGNATURE OF OWNE:
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SIGNATURE OF CONTRACTOR: ,f`�,�� Sl
SWORN TO AND SUBSCRIBED BEFORE ME THIS
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AS TO OWNER:* *�"M�ssion f
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SWORN TO AND SUBSCRIBED BEFORE ME THIS
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TO CONTRACTOR* Mrcon,mi„io„
EviesAwwa.2oa4 NOTA 'Y PUS`IC
Liability Insurance Supplied sv
Workers Compensation Insurance Supplied
Contractor License Information Supplied
Occupational License Information Supplied
CITY OF ATLANTIC BEACH
800 Seminole Road -Atlantic DEPARTMENT OF BUILDING
33 -
233 - Tel.
ROOFING PERMIT
(904) 247-5826
PERM iT INFORMATION
Permit Number: 20944 LOCATION INFORMATION
Permit Type: RE-ROOF Address: 1971 MIPAULA COURT
Class of Wes: NEW ATLANTIC BEACH, FL, 32233
Proposed Uy: SINGLE FAMILY Township: Range:
Lot(s): Block: Book:
Square Feet Section:
Est. Value: Subdivision: SELVA NORTE
Improv. Cost: 5,890.00 Parcel Number:
Date Issued: 11/08/2000 OWNER INFORMATION
Total Fees: 60.00 Name: KOLSTER, CONNIE
Amount Paid: 60.00 Address: 1971 MIPAULA COURT
ATLANTIC BEACH, FL. 32233
Date Paid: 11/08/2000 Phone: (904)247-6501
Work Oesc: REROOF __ _
CONTRACTOR(S)
ARLINGTON BEACHES ROOFING APPLICATION FEES
PERMIT 60.00
Inspections Required
NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
Q Cl"'� CHECKS CITY OF ATLA TIC B CH ;eaRr; ,.
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