79 Shell St re-roof permit CITY OF ATLANTIC BEACH
.s 800 SEMINOLE ROAD
J _ ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
IOBINFORMATION:
Job ID: 16-ROOF-2719
Job Type: ROOF PERMIT
Description: re-roof FL 10124-R19
Estimated Value: $9,400.00
Issue Date: 12/6/2016
Expiration Date: 6/4/2017
PROPERTY ADDRESS:
Address: 79 SHELL ST
RE Number: 169583-0000
PROPERTY OWNER:
Name: BOLE, BRUCE S
Address: 79 SHELL ST
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 $97.00
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $101.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
f� C 1 c L L Office(904) 247-5826 Fm(904)247-5845
Job Address: 1-t .� n�1 Sh-f Qe_l A'I�fillllf BC���_��2��t_ Permit Numbcr:
LOT I BM•l --
I,c»::19)esc:i(>tiunl5-R]_. fw a100TArea01 {Vp qlh 7tm7 Pare• e 145
q Q.A'6�Qb -.._
Floor Area o t
VLduatioae of Work$ q, H� Proposed Work heated/cooled 2543 non-heated/cooled 514-
!a,�
4-
,_..,.t,Wore.(circle one): e. Addition Alteration Repair Move Demolition pad/spa window/door
Use otexistia8/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire spnler system installed?(Circle one)�o r
Florida Product Approval e�uct approval For multiple products use product approve ora
Describe in detail the type of work to be performed: 1\I�t rep IQ(,�Y11 en 1
rr:`rty Owner information: p
Address:]l Iniv 322 ------_.
��19lYL�J..l� 014� Lpp m2 Phone I .---- ---- --
;: lot H s k (O tional
Contractor Information: II I
Company Nam : b Qty in Agent: e1� N rate
Address: ( T i City State Zr
Office Phone - - 1 b S,1'ltf��Cgqntact Number
State Cenifcation/Registrafon A ► 11X01
Architect Name& Phone#_
':. at:.ineer's Name& Phone ...—
Pct Simple 1'aie Holder Name and Address
Aouding Contpany Name and Address_
Pxturgage tender Name and Addross
Application is hereby made to obtain a permit to do the work and installations as indicated /certify that no work or installation has commenced prior to
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes
and roid J work is mu commenced within six(6J months, or ifcoutruction or work u suspetided or abandonedfor a Iod of six/6)monthrBofle�rs,I Neal
work ix commenced 1 understand that separate permits most be secured far Efedrice Work, Plumbing.Signs, Wea Pools, f..on,
Tanks and Air Candid men.de,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
T "Y1 UiZ PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR TENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
i in+r•1„ rov!r Ilia i i,o.- ad,,q examined this aetpli.don ail tie m be true unJ tturect, allayynvirions rj/was end main.
A " I f .d I th 1 edur s eelft d hmei. a (>" ting ,f a per r dors not p+ me to Xnr n nh,,rn, ro
-. ry 1",Jld�.raL.tot ., lxul�w regnlrumg rnn. perfimma a Jn.netru<aon a
?R
Signature of OwnerX Signature of Contractor n D
,Ia < r r,1nn So <
Print Name GU4_le..__......._..___._.__....... _. .>._ o Print Name .._y,p�uR4O.T . .... .. �1p.!Cu. .a n..,..o ..-.
.. ...
Sworn to and subscri a before me a;- c Sworn to and subscrib before e
s3 -Day of .rs ljv 201 �, $ this �Day of —✓ m
_ OTiN I .ITN
x
No Ic
" m A Revised 01.
A
Doc Y 2016265522, OR EK 17782 Page 984, Number Pages: 1, Recorded 11/18/2016
at 12:23 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
PNEOaRE N WGLIGIEt
pa ad NoTex FMo No
9M,e o7 Pam Courcy of Duun
Towhom h may coneem:
The undOMIMW hereby Informs you that impfo ..h,,will W maAa to Ca nja read property.end in
accordance Men Secfian 713 of the Jet Statutes,me bibwlrg irdotmatlon Is ztabtl In mN NOTICE OF
COMMENCEMENT.
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