367 Belvedere St roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-1928
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES 3/12 PITCH
Estimated Value: $7,290.00
Issue Date: 8/24/2016
Expiration Date: 2/20/2017
PROPERTY ADDRESS:
Address: 367 BELVEDERE ST
RE Number: 170703-0266
PROPERTY OWNER:
Name: LINSELL, IAN KETTLEY
Address: PO BOX 330331
GENERAL CONTRACTOR INFORMATION:
Name: HANSON ROOFING INC
Address: 2714 CORTEZ RD QA JEFFREY DONALD HANSEN
Phone: -
FEES:
BUILDING PERMIT FEE $86.45
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $90.45
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 �v -2 b0 _ 19 Zt,
Job Address: 3(o? Jl[.I✓e.cCtC• 5 t. Permit Number:
Legal Description 3S—!a i.t !( - 55 .14[ a,,.i tai35311krcel#
o PCwrArea of q.l i�
Valuation of Work S�Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New AdditionlteretioV Repair Move Demolition pool/spa window/door
Use of existing/propposed structure(s)(circle one): Commercial
If an existing structure,m i
a fire sprinklers stem nstall ?(Circle one): es No N/A
Florida ProductApproval# - 1 17`d•S
For multiple products use pro uct approve o-m
Describe in detail the type of work to be performed: Re f,if, �><`S -T 2,,r Qj�
742 Slay
Property Owner Information:
Name: Address: //�5�u,{.h ion / Lm
City State Zipj2Qjj:ZPhon'e 6Y-2i -00.5+
E-Mail or Fax#(Optional)
Contractor Informa
tion:
Company Name: J!t w'a Qualifying Agent: �+M"e✓ k7 lfe rr.Sov�
Address: izel. City sano.((e l State Zip.Lm'L
Office Phone f _ t —G"ii sr Job Site(ConiecK Number 964-333-9o& Fax# Yo4-o4t - &3z5-
State Certifi r' /R 'st,ar: # P f CL2 /8-1,5-
Architect
f/SArchitect 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 apermit to do the work and wattlatiom as indicated I cert f,that no work or installation has commencedprior to the
issuance ofa permit and that all work will be performed towel the standards ofall laws regulating construction in lhisjvrisdiction. This permit becomes null
and void fwork is not commenced within six(6)months, or if construction or work is susyeW ed or a�nedgfor o ri 6)mora/s at any rime er
work is commenced 1 understand that separate permits most be secured for Fletf//rvl s ns, Wd 6o1bs,// ns,
Tank,andAlr Condiaoxm,N
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.
l hereby certify that I have read and examined the plication ardbro the same m betrue and correct All prmv iom oflaws and ordinances governing this
type o)work will be complied with whether sppeecct ted herein or not The granting of a permit does not presume to give authority to violate or cancel the
provenom ofany other federal.state, or local taw regulating construction or the performance ofcomtruction.
Signature of Owt Signature of Contractor
...., _ __...... .
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Print N a is Print Name
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Sworn to and so 'bed bef me Swo"and su ribed ore me
ay of 20 l0 this Day of 20
Nublic ALYSSA SUTERToo"I 1c��r„�
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WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AMR THE EXPIRATION Of THE
NOTICE.OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMEIVIS UNDER CHAPTER 713.PART L
SECTION 71113 FLORIDA STAIVIFS, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMMOVEMENIS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON TRE JOB SITE BEFORE THE RUST INSPFCWR IIF YOU(MEND TO OBTAIN FINANCING
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
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