630 MAIN ST ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
y ?} 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-1312
Job Type: ROOF PERMIT
Description: RE-ROOF- SHINGLES
Estimated Value: $7,425.00
Issue Date: 6/8/2016
Expiration Date: 12/5/2016
PROPERTY ADDRESS:
Address: 630 MAIN ST
RE Number: 170915-1500
PROPERTY OWNER:
Name: KELLER, MATTHEW D
Address: 630 MAIN ST
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES:
BUILDING PERMIT FEE $87.13
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $91.13
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road Atlantic Beach,FL 32233
�""yywrt-st Office(904)247-5826 Fax(904)247-5845 ICO -ROOF- 1312
Job Address: ro /»Wn ��PermitNumber.
Legal Description,/fr;J19�],$ 4 a.1 �� !c �r jkd! Parcel#
Valuation of Works ��//,f-t L• p� ,or -a, ey` 't— - -----Sq Ft
1LIAProposed Work heated/cooled bon-heated/couled
Class of Work(circle one); New Addition Alli epau Move Demolition 11001/spa windowldoor
Use of eristing/proposed structure(s)(circle,,,): Commercial
Han existing structure,is a fire spriu er system fastaCom(Circle one): Yes o N/A
Florida ProductAppmvule0-741-
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Describe in detail the type of work to beperformed:QOA� rl �' _$/ 2
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State CettiCoetron/ttegiswtion
Architect Name&Phone#
Engineer's Name&Phone# —
Fee Simple Title Holder Name and Address •/
Bonding Company Name and Address
Mortgage Lender Name and Address
APPliarliart is hereby made to obtain aPll& to do the work and inndladom ar iM,'rnred (earth that rto work or irum(lodun hm commenced
ismancr ofapermirmd�ha�all workwil/beper�ormed ro meet rhe srandardr afa!/laws regularing corwlram(on in rldrl adlcaen Tho ermn
and void� workanm commenced within sis(6 moor/v,or ifconmvttlon or workaaurDerMedwabandmred oro �� Prrm ro drz
wink u cdAJ, ,, /undenrarrd am mparah p¢rrnirr mun be renryd for EYeerr/car 104de par P becomes md(
Tmel�mrdAtr CoxrBr/aners,arc rnb(ng,Si n; tel °frit 6J months ar arry dinea�tear
S �' !q Pools,�mnoss, Barley,Hmlen,
COMMEMCEMMEEVTO
MAY RESULYOUR YOUR FAILURE YING RECORD
WICE A IMPROVEMENTS
OF NTS
TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCINGCONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO'[JR NOTICE OF
COMMENCEMENT.
lhwrbyy certify tlmr l huve rends, ed alapp(ic and know the some to be mre andc
.,qc q work wB/o °mp/4:d wp ' rker c!red b,s, cm. ru ,tree[ A(1 povuions o /owr and ordinances overnin Ihix
.P nv4,'aru oja,ry that ,s r! l grmuirt8 I a permit doer norpe".ame m f 8 8
A�!.CA / v reIDrlaang ca acriart a the Performance o/conrm¢rton. 8 authoriry ra vio%n or ,cal roe
y,i ttnaatduurre of er
/r Signature of Contracrer
Print Name
---- Print Name
Swum to and sulxcri before me --"-eT-------._.—
W 'J Day of 20/( Sworn toand subsc " ed before me
this Day o !
Wary b
DAVID DALE B SETT JR
Coen,...... rr .lsrvs """° „ DAVID DALE BASSETT JR
My con,n,�es mrxpves Cammisslonn FF zlevs Revised 0126.10
,. .. Apill 07, 2019 MV Commission Expaes
April 07, 2019
Doe t 2016129294, OR BIC 17590 Page 186, Number Pages: 1, Recorded 06/08/2016
at 11:43 AN, Ronnie Fussell CLERK CIRCUIT COURT DUVA COUNTY RECORDING $10.00
NOTICE Or COMMENCEMENT
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