342 Seminole Rd roof permit ?� CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
a
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ROOF-2839
Job Type: ROOF PERMIT
Description: RE ROOF
Estimated Value: $4,700.00
Issue Date: 12/20/2016
Expiration Date: 6/18/2017
PROPERTY ADDRESS:
Address: 342 SEMINOLE RD
RE Number: 170431-0000
PROPERTY OWNER:
Name: DETUCCIO, KIMBERLY H
Address: 342 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: ROOFING LABOR INC
,CCC 1330801
address: 112 BEROT CIR ST JOHNS, FL 33259
Phone: 904-437-7530
FEES:
BUILDING PERMIT FEE $73.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $77.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904)247-5845 (j - Koop- zS3 /p
Job Address: -S4Z 5iP,YY1indf, Rhad 6104BA,FL 37,133Permit Number:
Legal Description I015 IU-2S-N9 5e47 Sa, Air L1 t 2b7 Parcel# QQD 31 -000
�looT� —S�t. CoCq r
Valuation of Work$ Proposed Work heated/cooled U Z non-heated/cooled1588
Class of Work(circle one): e
Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/p m osedstructure(s)((circle one):. Commercial srdential
If an existing structure,i's a fire s rnnklgr s ��tecm insta=7fCimle one): es o /A
Florida Product Approval#
For multiple products use product approval form i� ,�I
Describe in etail the type of work to be performed: 1'1[.r0(1� QI U mp I Q J
Property Owner Information:
Name:K If11 b r LU D L1f,Gl 0 Address�Z Seitiole,�
City h ( State Zio 2233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:R06i It n Q �f1G. Qualitying A ent: l7Y'D11 r�u M oh+,,& .l
112- -2-2 �„bwx City -- `State Zi 32264
Office Phone C`104-31-14- 4534Job Site/Contact Number - - Fax# 4
State Certification/Registration#C C C_ 13 30 M 01
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 a permit to do the work and installations as indicated I certify that no work w installation has commenced prior to the
issuance ofa permit and that all work will bepe orated tomeet the stondards ofall laws regulating coma tion in this jurisdiction Thts permit becomes null
d f
andvowork u not commenced within six(6imonths,or ifconetruction w work is suspended w abandwredfor a period ofsa 1P6)months at any time after
work is commenced. I understand that separate permits must be seared fw E/ecirlcar Work Plumbing,Slgns, Weaa,Pools, umaaea,Boiiera,Hea/or,
Tanks andAlr Conditioners,da
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.
I hereby certify that l have read andexamined this plication and b a be true aid correct. All provisions of laws and ordinances gave
type of work will be complied wish whether speci9d herein w not of a permit does not presume to give wskZiy to violate or c
provisions ofarcy other federal,state,or/peal law regula(ing consnv '@'! rformaace ofcons[ruction. _ _
Signature of Owner � ^•"p Signature of Contractor D
y 1, Ei
Prim Name _k1i21F7GIra............J.1.C2F1dk,L.'`.�............
_ ` 5 o Print Name .. ...... _.. ......... ....
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Swom to and subscribed fore me 3 ; �.D Swum to and subscrib before me
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NotaryPublic Clow,j 4, 11AA y11114 0=_ m mNotaly Public , dArletr Vo tf
Revised 01.26.10 i0
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Doc M 2016283529, OR BE 17808 Page 319, Number Pages: 1, Recorded 12/13/2016
at 10:44 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
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