1225 Hibiscus 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 NEXr DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-2532
Job Type: ROOF PERMIT
Description: re-roof
Estimated Value: $9,208.00
Issue Date: 11/10/2016
Expiration Date: 5/912017
PROPERTY ADDRESS:
Address:
1225 HIBISCUS ST
RE Number: 171058-0050
PROPERTY OWNER:
Name: OSBORN, STEVEN F & MONICA,
Address: 1470 MARSH VIEW CT
GENERAL CONTRACTOR INFORMATION:
Name: GREAT WHITE CONSTRUCTION INC
,CCC1329097
Address: 4320 DEERWOOD TRAVIS SLAUGHTER
Phone:
FEES:
BUILDING PERMIT FEE $96.04
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $100.04
PERIVITY IS APPROVED ONLY IN ACCOW)ANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND Me FLORIDA
BUILDING CODES.
?I
r
BUILDING PERmiT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
office(904)247-5926 Fox(904)247-5845
Pa. I�D-F-00P-r)s��
Job Address: VU-S kKk�,,, 1pffik� it Numben.
Legal Description S:7,4 VA-V 731 Paged# 'q
� nor M-WM 4.".
Valuation of Work$ -1 91ri qd WO',rk beatetbicooled
L n ri-heated/cooled—
_.L� po
Class of Work(circle one): New Addition Alteration ll� Mme Demolition pooUspa window/door
Use of existingvp=sed structure(s)Irle one): Commercial denti
If an existing stru umissfiresprin r system installed?(Circle ont):Sa�o N/A
Florida Product Approval 4 f
For multiple products use pr6.iw .16MA47�Tvc—
Describe in detail the type of work to be pofornted: Q)V_UD�7_ I
mdog � oA+
proper"owner Information:
N N Address- V12S A�k"661W—Z
'Lizip 3y� P
State 41_�Zi .�,
—Y p
E-Mail or Fax#(optional
Contractor Infarxestion: Qa1ifyingAg=t1V-"S
Company Name: \OWAL fttMof Staft Zip 3Z.Z_
-city
Fax#__TdL�L��
State Certification/Registration i
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Ad
Bonding Company Name and
Mortgage Lender Name and Address has onanstnerd plin,In ON
tdo 'Wd rMir beoo�viff
"'s has
am
a" 'aa-"r':,
a"
CE OF
ROW,
of
' an
d S -a
ar'
UR"
ONSULT
4 ZRN 0 ""n 0 r __d*-'a" 'I'aa FOR NOTICI.1. 11.1after
'cona"a ar'w"' (6 st 'a 4�_`w
K-'o a
"C
T-1. A
W 0 0 A
YOUR F L C
Y A G G
NT KA RE ULM M � � �
W 0 0 P T Y
as_'� To 0
CO A Y S MENTS
YO ENCE, OU I B 0 WITH
TT �� M MW
0 0
uR FO C
r
T
TO PROPER 0 Y B EOF
YO LE R OR COM NCEME
.d
,yp, . ..rk.111 b, 0.,,iied with whkaher i a hema, a, a, nw graving of a�ratu does na�pm,wse 10 Vw�hafsy 10 v'01's' ar�amfl
Signature of Contractor
Signature of 0:���
PrintName A Print N
S" to and subscribed before me Swom to and subscribed
to this ?( Dayof Q21M?1QM .201(,l
this 1 1 Day of UMN
N bli MY MMISSION1#FFWW2 AROM INT011 1, 01.21.11
EXP Janus�23,201 B ap"Psaft-IR001HAP
1,3isaIN F 1. S.,nas. Igmamm 0 06 031300,
tFE, Lox is C)#V 1"
Doc # 2016257321, OR BE 17770 Page 2309, Number Pages: 1, Recorded
11/08/2016 at 03:46 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMZNC'CMZNT
PW�NC�� cmmd
awa --Qr1q
T,wd,,Wwd�W.kFkfMjl k4==dMlSMd Ingo NOTM OF
SEC H Atlantic Beach LOTS 3A BLK 231
1225 Hibiscus St Algotc Rpnrh Fl zidaa2233.—
Reroof
0� Steven Osborn
arsh ewCtAtlantic Beach Florida-1971.1
o0w, M�Wft p
F�2
rea ite onstruction
eerwo a a ille Florida
z —7— 866-746-7 W
�Z'94-4-4-4-4725
FUH�
wft CwAmxftn dow ftm�
Faft
madw
Ad*m
FUND_
z
IM
z
�M-1AALffJJ—