982 OCEAN BLVD - ROOF , r ✓J ,
,6� ' \s� CITY OF ATLANTIC BEACH
8(H) SEMINOLE ROAD
V)'if .. , , i 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-948
Job Type: ROOF PERMIT
Description: ROOF
Estimated Value: $13,000.00
Issue Date: 4/22/2016
Expiration Date: 10/19/2016
PROPERTY ADDRESS:
Address: 982 OCEAN BLVD
RE Number: 170342-0000
PROPERTY OWNER:
Name: ROULEAU, DAVID W
Address: 982 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: MONAHAN ROOFING
Address: 2050 S KING CIR QA THOMAS L MONAHAN
Phone: - -
FEES: -- - - - ----
BUILDING PERMIT FEE $115.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $119.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 2 Dcen.., g i�Qi Permit Number:
Legal Description /Si 6. sr67 —2 5—2Q�z,,17 i- 7 / 6 tt
Floor Area of Sq,F•t. Parcel#t. Ft
Valuation of Work$ 13. C)00 0 ' Proposed Work heated/cooled
non-heated/cooled
,,se"
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial : -sidential
If an existing structure,is a fire sprinkler system installed?(Circle one): •es No N/A
Florida Product Approval # FL 19 _C(� Ft.,.5 s
For multiple products use product approval form
Describe in detail the type of work to be performed: 12 ro, F. co,,,,P IR. 1-c_ , j-i o u i
Tr et-A,r.,..s-
Property Owner Information:
Name: Qrve,,. Atli s,r re ►^ Address: 94' 2 p c,ti,. Chi„ .
City / Fio,"rA c ,6 ,,A c< StateFL Zip Phone S' / - 310 4,
E-Mail or Fax#(Optional) 1,r/a vi W o� SSn er�l c 44 a,AC4-.i
Contractor Information:
Company Name: (fo,ta.r.�-. 2co Fr rr Cc,,,,t rc c,,,l ltic Qualifying Agent: iv/A
Address: ao.co 1c.,.}, C.,(-c.c.- City n epl-c.„, Qes,c-,, State pi., Zip
Office Phone 2 2i —a o s c Job Site/Contact Number 7'o,,,, s C,Q_y c,a - Fax# I
State Certification/Registration# /2.c 0 o ti 7 3(a'
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 certifii that no work or installation has commenced prior to the
issuance ofa 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 ElectricalpWork,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 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
provisions of any other federal,state, or local law regulating construction or the performance of construction.
S• azure of Owner- L� , /
Signature of Contrac .r /_4�� �i;
IrintName .4
4/6‹,5.„541 --X.., ,
Ea Print Name I r"'" 4 rY) .,a h.. .-).
Beforg me y I / Bef. , r
this .L of P _ �° thi r A Day of •ll t a , 20 /Vi
'�` r.°°01 ASHER KELP
Public •, - • — - . . 1 Ada
s,:3" s Commission•FF 972890 Not-Iy '�� :r L ROSEMAR►EC.PERRY i
':'fpl � My Comm.Expires Mar 20.2020 MY COMMISSION s FF 941898
Via: EXPIRES:J anuary .e e• • 0.24.12
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