154 Belvedere St re-roof permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ILI" 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-2216
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES
Estimated Value: $7,300.00
Issue Date: 9/30/2016
Expiration Date: 3/29/2017
PROPERTY ADDRESS:
Address: 154 BELVEDERE ST
RE Number: 170577-0010
PROPERTY OWNER:
Name: TUTEN JR, WILTON E
Address: 154 BELVEDERE ST
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
,CSC12S6245
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone:
FEES:
BUILDING PERMIT FEE $86.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $90.50
PERNIFT IS "PROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904)247-5845
JobAddress: )5ft 6eA\Wduk !�tpmaxmc 6W)n �t3z�- Permit Number:
Legal Description� I r �s 4�n'M 0-l"', Scilt
Valuation of Work$-1 ST), to Proposed Work QeLedZlcooled— non-heated/cooled
Class of Work(cimle one): New Addition Alteration 0 nepm, Move Demolition pool/spa window/iltior
Use of existing/pro osed stmeture(s) circle one): Commemial Rdge—nna-1)
If an existing structure,is a fire sprin=system installed?(Cirele one): Yzr---No
Florida Product A proval4 M14-
For multiple paucts use product approvarrorm
Describe in detail the type of work to be performed: VMLWE Z&--4c
Property Owner Information:
Name: -TLX Address:MAr Gpekw&mte Pw�-
city StateFLZip 7)ZZ33 Phone !104r- ZW-�.jCjt:;'
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Qualifying Agent-
AL city -Stal jpt Zip 3z?k(0
lone i PA-1,'l-1 JoZ Contact Number iLgizj I-# &J&-14�UIAO
State Certification/Registration C C C 1 1
Architect 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 apermut to do the work and installations"indicated Icertf,that no work or installation has commmedprior to the
issuance ofatiermit and that all work will beat d to meet the standards ofall laws regulating construction m thisjurisifiction. Thispermit becomes null
and void ifivork is not commenced within sor(a0zo—nalts,or ifconstruction q,work is srmled or abandonedjor a
work is commenced I understand that separate permits must b securedfor Ele c N Wperiod of sb,16
Work, Signs, d )months at my time after
Tanks and Air Condfianivii,da c ch'i Plumbing fi;Pools, arizoes,Batten,Makes,
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 YOUi NOTICE OF
COMMENCEMENT.
I hereb,certify that I have read and cautioned this lication and know the mine to be true and correct Allprovisions afhaws,and ardbutious gumming this
OW o7work will be complied with whether 11..cif9d herein or not. The growing of a permit does not presume to give amhorz to violate or camel the
provisions of any asherfed.eral.state or local aw regulating construction or the perlormance ofcomhuction. ty
Signature of Oven" 24Z!21�. Ile !!T�_ Signatura of Contractor
Print Name U.-N. Print Name
....... ......
Sworn to and subse A beomme Sworn to and subscribed before me
this,ji2_�ftay of= ,iPtt �20/6 this 30ftay of
20
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$.WCOMPAISS10sloottimol Notary PUblioJ AV -
�j E)PRE&A*WA2M0 aW4M!=7:n FlorWj
Doi� # 2016226834, OR EX 17727 Page 1874, Number Pages: 1, Recorded
09/30/2016 at 08:58 AM, Ronnie Fussell CLERK CTRCUIT COURT DUVAL COUNTY
RECORDING $10.00
N(MCZ OF COMMENCPMENT
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