1480 Camelia 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 NE)IT DAY INSPECTION: 247-5814
308 INFORMATION:
Job ID: 16-ROOF-2718
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES
Estimated Value: $4,000.00
Issue Date: 12/6/2016
Expiration Date: 6/4/2017
PROPERTY ADDRESS:
Address: 1480 CAMELIA ST
RE Number: 171079-0000
PROPERTY OWNER:
Name: CREGAR, CHARLES
Address: 1496 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO &WILLIAMS ROOFING CONTRACTORS INC
Jeremey S. Rogern,CCC1330387
Address: 883 Lawhon Dr ST
Phone: 904-518-5463
FEES:
BUILDING PERMIT FEE $70.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $74.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CUCY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
goo Seminole Ro4 Atlantic Beacli,FL 32233
Office(904) 247-5826 Fax(904) 247-5845 (0-R.00F-- Z771 E)
IAO Permit Number: .------- -
L'tial Des -39 'St6���
criptioall%-,% , Parcel#
'0 Floor Ana UL zaq.s, non-
V,_Aiatiasi of Work$1&__Proposed Work heated/coolel
ft4- ' ion potil/spa windowIdoor
A'erLwiv:le sore): New Addition Alteration Repair
Use of existing/proced.structurea) circle ne)� Co ercial Resi
if an existing strue ure,is a fi a s in Install ircie one es No
Florida Product A -114 1 D-111 L
For multiple pruupcts use 017111
Describe in detail the type of work to be performed: 1-6 L-L
r Address:_)�q�
State1j:Z1p3Z2R0�Phm1e
Mod a 1,.,
Contractor Information:
Company me. � `i� —,�tate zi
city --�v ta
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Office Phone qQL1 S)Z52&1�2 JobSj;t3ej5Lnt&ctNumber q0lf �aj__�9Fas# -?Oq kIzi1002 is
0 3__ ..
State Certification/Registration
Architect Name& Phone#—
1 Name & Phone 4
_WdAddress I
!:v� �iyujfle fitie Holder Name as
lioriding Company Name and Address
Mo qage Lender Name and Address
4ankainit'sherel, ad,so obtain a permit to do the work and Installations as maherized I certify that no work m intallartan has,commencedprio,to
real, c es
and that all work will belwrf,,,,,,d to met the standards ofall laws regulating construction in thisjurissfiction. Thispe be oin
issionneojaprient s riod.0afinnualamosietmea
d(6)months, �ifcowimction�w�kisffijd�d.,.&�d.n�dfrr
,N el Bel H
%torki,ccenoneaved I understand that sesnease permits must be secustaijbr Elftld IfiensPlumiungft"s, elle"umuls' '"'naces' Imes' em
To.ksmalAirC."dithowmete.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENT�,
Ir
��r 04jf
- < PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT W17 0
YOJR LENDER OR AN ATTORNEY BEFORE RECORDING YUR NOTICF Ov,
COMMENCEMENT.
....it exnivied this qppircation and k w the sa etotui......od"u,,cf, P"n'lown,"y I.......sel,'hn,vi...
...........lied,dohnilwA,sp,il...liuu�mar,a,
Signature of Own Signature of Contractor
Print Name
Print Name OFMA
Sworn to and subscrjibed beforT me Sworn to and subscribed 0 Is in
thisjQ Day of 20 /6 this3,J Da of 20
otary It
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201 in im July 24. 2017
7
July 24. 201
Doc # 2016276924, OR EX 17798 Page 2149, Number Pages: 1, Recorded
12/05/2016 at 03:08 PM, Ronx,ie Fussell CLERK CIRCUIT COURT DUV� COUNTY
RECORDING $20.00
NOTICE OF COMMENCEMENT
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