38 Dudley - Roof Permit and NOC Doc # 2016219573, OR BK 17717 Page 1722, Number Pages: 1, Recorded
09/21/2016 at 04:04 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Y61v
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-2378
Job Type: ROOF PERMIT
Description: Tear-Off, Re-Roof, 3-Tab Ashpahlt Shingles, 5'12 pitch, FL
16638.1, 18sq. NOC submitted.
Estimated Value: $6,500.00
Issue Date: 10/21/2016
Expiration Date: 4/19/2017
PROPERTY ADDRESS:
Address: 38 DUDLEY ST
RE Number: 172207-0000
PROPERTY OWNER:
Name: HOBBS, CARLOS E
Address: 1806 INDIAN WOODS DR
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
,0003329097
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone: -
FEES:
BUILDING PERMIT FEE $82.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BDILDDMG CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fex(904)247-5845
Job Address: Ie o,nws a<a•nas•mn n mess Permit Number:
Legal Description 191617.25-29E DONNERS WP PTLOT 3 N 12 LOTS SLK 2 Parcel# 112207-0000
Floor Area of sq.H. 7q—Ft--
Valuation
qtValuation of Work Sssese Proposed Work heated/cooled two non-hwted/cooled
Class of Work(circle one): New Addition Alteration (RijiD Move Demolition pool/spa window/door
Use of exirtinglproVosed strurture(s)(( sole one): Commntaol denn
[fan existing structure,is a fire sprinWer system installed?(Circle one): Yes No
Florida PmductA pmval# FL,ee.,
For multiple pro nets use pr uc approve orm
Describe in detail the type of work to be performed:Tww•e R.vrvlo-ae rceb•—'o,svrm.ares..,
Prooerye Owner Information:
Name:cmm.Reaa. Address:ee.ewsa
CityStater= m
Zip as Phone w.wane
E-Mail or Fax#(Optional)
Contractor Information,
c. ..m . tt2au i�S 3luucylctDt/G
Address `lame: Qualifying Agent:
Address City m`Z% Sime n Zip T
Office Phone_.. . • Job Site/Contact Number _ Fax# Sl.IIaZMaIYM-1
AlateCurtis tectNmti0n/Regie[fati0n# 1zih�
EngineGNamee Phoneq
Engineer's Name&.Phone#
Fee Simple Tide Holder Name and Address
Bonding CoupeNo= Address
Mortgage Lender
meName and Address
Apollwoon is hereby mode to wanln entrust to M the workmrd ldmllalloM at,Waitress Iscrlti that no work w sonadpdon has Muu<roupdor to IM
IsrvaMYo ao rmstaM,Midi work will benrr/(rmedlo met,IM nen6aM,o/Wllawa rcgulalln8[aMlrv[ran In lFir/unrv#nlon/ na"nullMrouernall
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Tong, IA4Candhlow—,,na
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
TO YOUR PROPERMMENCEMENT TY IF INTENT IN D TO OBTAIN FINANCING IMPROVEMENTS
O SULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
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Signmureof0 er // Signature of Connador
Priat Namc Y is Print N. Tytw�L SIU
Sworn Sudan rcrb d efore me S.to it subscribed be m�e,,
this Day .20/0 this LDayof ACTV<1Gla• .2010
Nota, ublic omry W.
Revised 01.26.10
KRISTINE SANTDS
Nolay PanicSlalto I Fbritla
LOP/,KNOPF ?• - Commbseen I RG 071700
�f r Public Sttle of FloridaIT
-MY Comm. Espires Sep to.2020
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Commissi0n I. Bonded tdlougn Nasional war,Assn.
s'y . My Comm.Expirae Dec 20.2019