1072 Little Cypress Key re-roof permit ,S 1y1i`lj
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' CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
' ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 16-ROOF-2064
Job Type: ROOF PERMIT
Description: re-roof 30 squares 7/12 pitch shingles
Estimated Value: $15,137.00
Issue Date: 9/14/2016
Expiration Date: 3/13/2017
PROPERTY ADDRESS:
Address: 1072 LITTLE CYPRESS KEY
RE Number: 172027-5822 _
PROPERTY OWNER:
Name: SWANN, STEPHEN C & KIMBERLY, '
Address: 332 THIRD ST
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
,CCC1330387
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES:
BUILDING PERMIT FEE $125.69
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $129.69
PERMIT IS APPROVED ONLY IN ACCORDANCE WrrH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPL:_ATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Joh Address: 10% _ 3712?63 Permit Number:
Legal Description SAO 1R&S.ltnlf3 (af7/S� Parcel # Itof St&-DL
FToor�a of q. t. q Ft
b'alnatiorr of Work$ I X13 Proposed Work heated/cooled HIS' eon-heated/cooled c03l¢S
Cts:s of Work icircle one): New Addition AlterationRepair Move Demolition 1a,Vspa window/door
Use of existing/proposed structure(s)((circle one): Commercial Residential
If an existing structure,is a It H tent installed?(Circle one): o
Florida Product Approval # - t.w),kria"q ,rtd^ ek,-o FL(S d( Zo
For multiple products use product approve arm
Describe in detail the type of work to be performed: I&Yr777�- 30 S�q Uff'r10 S
!'rUnlrty Ownet�toformatinn: 'y1
'•�an;c: hLr) �J_W__&r)r\_ Address: 1009 Liat! Cl.tPce-SS
-_�.LkW—C,S&E�_State, -Zip D6l.3 Phone 90 '3 • OLJ1
FSMaiI or Fos #i0ptional) _
Contractor Information:
CompanyN pe: a it 01 5 QualifyingAgent:�GfyA*rs
Address: 3 I f1 City tate Zips
Office Phone 1p Job Site!Contact Number QO U• SSS•7.Y7D Fax# dl0 • 8 7r1/
State Ce rlificatim/Reaistlation# (",(.' l 3 3 0 319
Architect Name&Phone#
i':ngiaeer's Name& Phone#
Ft:t Simple l'itle Holder Name—
and Address P06f-r0 S U)'A 1&, 5
Bonding Company Name and Address
Mortgage Londer Name and Address
Application is hereby made to obtain a permit to do the work and imtallationr as indicated. t cert that no work or installation has comenewed prior to
issuance ofa Mrmil and that all work will be per armed to meet the standards ofall laws regulating construction in this jurisdiction. Tha permit becomes.
and void J wink u not cnmmrnced within six(6)lmonths.or ifconsouetion or work is sysperMed or abandoned jar a aeriod ofsu/6J months at any time a
ark i.,canmrmed I understand that separate permits must be securedfor BledrrcN Work, PhuaWng,Signs, W'As Pools, FYmaov;Bo11—,Heat
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENP,
,1.0 YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCINGCONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOIUR NOTICE OF
COMMENCEMENT.
rn la cern/r din l lis w read and ea'ami wd this application and k w,the sante a befrac urd crnrect. :th in aviriow,+f lava and mdiaanee.,;go", wit•
A l+h. a nplird with w hrdur specij d herein ar and The grantigg+J a permit dors nm imesumr to K++'r rnnhm'im m vldalr r:oma
r;. i tvfnlend. sate orfuulla, rrala/ing conxvauinnwrhe pe+fmmamr ofcuastru, I'm
Signature of Owner C Signature of Contractor
Print Name .... .. �4.�.n _ •✓v.L�S.:C/.II_ _ Print Name 77 .....
_ _..._
Sworn to arid subscribed bef re meSworn to and subs cri d before e
this 3 (_Day of .-tT .20 /6 this 3) Day of .20 /b
1 chlic — LR BERT CA SETTA
MUt ROBERT CABSETTA
*.l Commission4 rr a81 Sa
eommism;ssr rr aal aB My eommissmn EP,109 sed 01.26.10
-` My Comssion Evairss 1«nrf July 24, 2017
3+.,.,,.. July 24, 2017
Doc 1 2016210286, OR RK 17705 Page 648, Number Pages: 1, Recorded 09/12/2016
at 11:10 AN, Ronnie Fussell CLERK CIRCUIT COURT DUl COUNTY RECORDING $10.00
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