1048 LITTLE CYPRESS KEY - ROOF 01-Alto,
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CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
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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-1638
Job Type: ROOF PERMIT
Description: re-roof 30 squares 6/12 pitch shingles
Estimated Value: $4,593.00
Issue Date: 7/20/2016
Expiration Date: 1/16/2017
PROPERTY ADDRESS:
Address: 1048 LITTLE CYPRESS KEY
RE Number: 172027-5816
PROPERTY OWNER:
Name: REVEL, EDWARD & PATRICIA, *
Address: 1048 LITTLE CYPRESS KEY
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES:
BUILDING PERMIT FEE $72.97
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $76.97
•
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
C
BUILDING PERMIT APPLICATION .
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 1140' (2-DD F 0 b 3'
.iob Address: J Q1. it_ ____C� -- 3a.? 33 Permit Number:
Legal Description /1 lPO /4-0?5'a 1��1 cd1nd 3 �iI-/a� Parcel # / /7,20,2 (2-51/ 6,
�/ Op oor Area o Sq. t. SgFt
Valuation of Work$ 't 93 Proposed Work heated/cooled /7/5"
non-heated/cooled -2Z Y ........
Class of Work(circle one): New Addition Alteration 'ep. Mov• Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 'eside
If an existing structure,is a fire sprinkler system instled? (Circle one): 'es No N /A
Florida Product Approval # FL/067'f'g-l0 U/e imeitcle(r''Q " pro ,q-co-‘0,- Fu7vzo
For multiple products use product approval for
Describe in detail the type of work to be performed:RQ(1 3 0 s9U..ace..,A
__________ 401, gi-eik s A;,"1 e s
'ropertS (Owner Information:
Eket--r . ve 1. Address: r0Oe � l' —Stat - Zi ZZ33Phoneo75`t/y _ 5P� __-` ------- --
. -`,i;::; or Fax 4 (Optional) — ---- — — -- — -- ..-
Contractor Information:
Company N.me t!o • o m /e &C6 6 .tOl W'3 Qualifying Agent: /ere / SC/fb
Address:3 MIN Stmt
/ 4 1• St / 4 State F Zip 32 7_5nOffice Phone*, 3L Job Site/Contact Number # . Fax# 90y, tel 6.1/77/
State Certification/Registration#_—SCC (3 3 0 3 l2'.
Architect Name & Phone#
:..: :l er's Name& Phone# ___-- --
_..e Simple Title Holder Name and Address '0 r+`' _ 3`�(� / __��x.E_�.3_4Z-_510.
: . ..d;ng Company Name and Address
% orl.Lage Lender Name and Address -- -----.--__._.__----..--
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
sstaanc•e 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
:a void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period ofsix(6)months at any time after
i::commenced I understand that separate permits must be secured for Electrical Work, Plumbing,Sins, 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 BE BEFORE YOUR NOTICE OF
NT.
,•in :..r•tity that I have read and examined this cpplication and know the same to be true and correct. .All provisions of law. and ordinances;'ov�ernirtg,r';i'
..ork will be complied wspecified with whether speced herein or not. The granting of a permit does not presume to give autnorit) to violate or canto .,?,
> r r-
, of other jederal.state. o local law re dating construction or the performance of construction.
Signature of Owner r
/ Signature of Contractoron
P �-,� Print Name ,. :1r41/
,� . ,* . .
Print Name ,A, I
Sworn tp and subscribed before meSwornvo and subscribe. .-fore me 204
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