671 SELVA LAKE CIR ROOF PERMIT .,,,„,\.,,„
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' �\ CITY OF ATLANTIC BEACH
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OF `.., yr 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-1508
Job Type: ROOF PERMIT
Description: RE-ROOF SINGLES
Estimated Value: $6,200.00
Issue Date: 7/1/2016
Expiration Date: 12/28/2016
PROPERTY ADDRESS:
Address: 671 SELVA LAKES CIR
RE Number: 172027-5888
PROPERTY OWNER:
Name: ROBERT, JOHN A
Address: 671 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ROOFING OF JACKSONVILLE
Address: 1720 Wildwood Creek LN
Phone: 904-385-4375
FEES:
BUILDING PERMIT FEE $81.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $85.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 1(.0_R o -- - ` 6 08
Job Address: 671 Selva Lakes Cir Permit Number:
Legal Description 44-60 162S-29E SELVA LAKES UNIT 3 LOT 148 Parcel # 172027-5888
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 6,200.00 Proposed Work heated/cooled 1 775 (10 non-heated/cooled 2,414.00
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # FL1956.3, Alas Synthetic Underlayment FL16226
For multiple products use product approval form
Describe in detail the type of work to be performed: Complete tear off and Re-Roof
Property Owner Information:
Name: Robert John Address: 671 Selva Lakes Cir
City Atlantic Beach State FLZip 32233 Phone (904) 962-2547
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: American Roofing of Jacksonville Qualifying Agent: Daniel P. Kinkel
Address: 1015 Atlantic Blvd. # 352 City Atlantic Beach State FL Zip 32233
Office Phone 904-385-4375 Job Site/Contact Number 904.226.1205 Fax# 904.853.5318
State Certification/Registration# RC29027546
Architect Name&Phone# NA
Engineer's Name&Phone# NA
Fee Simple Title Holder Name and Address NA
Bonding Company Name and Address NA
Mortgage Lender Name and Address NA
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 if 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 Electrical Work, 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 herebycert a that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of ork will be complied with whetherapeci red herein or not. The granting of a permit does not presume to give authority to violate or ca.cel the
provisions of any other federal,s te,or local law regulating construction or the performance of construction.
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Signature of Owner Signature of Contractor // /,Gliel-'
Print Name `"`��
Print Name Q .�' J 00V /a ://1
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