310 Skate Rd roof permit r i yL 11�5
CITY OF ATLANTIC BEACH
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
JOB INFORMATION:
Job ID: 17-ROOF-3071
Job Type: ROOF PERMIT
Description: re-roof FL1956.1
Estimated Value: $7,125.00
Issue Date: 1/23/2017
Expiration Date: 7/22/2017
PROPERTY ADDRESS:
Address: 310 SKATE RD
RE Number: 171657-0000
PROPERTY OWNER:
Name: WHITE, JAMES
Address: 310 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: SHORE ROOFING COMPANY
Thomas L.Shore,CCCO54811
Address: 914 7TH AVENUES QA THOMAS LOUIS SHORE
Phone: -
FEES:
BUILDING PERMIT FEE $85.63
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $89.63
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
Job Address: (2 Permit Number.
Legal Description -,N 1—16 3 A 2��i ' 7 S Parcel#
oor Area o qqt. Sq
Valuation of Work S '7 IRS, Proposed Work heated/cooled nou-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition poollspa window/door
Use of existing/proCpomdstructure(s)(circle one): Commercial Residential
If an existing structurc,is a fire sprm er system installed?(Circle one): Yes No N/A
Florida ProductApproval# [944 l
For multiple products use p uct approvaform
Describe in detail the type of work to be performed: Rc ROOF aS ye"'- TOM)a Sh INd/r S
� y AI� Igo,
Procerly Owner Information:
Name: Address:
City 1 6 State Zip 7J23T Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: - � Qualifying Agent:
Address: .= U City_ST State 1_1 Zip %�?•og•D
Office Phone ul .. 4 JJ- Job Site/Contact Number Fax#
State Ccrtiflcati r�kegisuation# C'['[' O 01911
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 u hereybyv made to obtain a permit io do the work and iretallatiau as indicated 1 rertify that.work or installation has commexed prior to the
isnome fa permiM thin all work will be performed m meet the standards ofall laws regulating cons"ction in this jurisdiction, This permit becomes null
and void fwork a not cane oed within six(6)months,or ifcom"ctim or work ts nded or abandom:d for aperal/snodpoffssu/6/months ai n,time after
work its commenced 7 understand that separate permits must be secured for Elemirnl Work,phtmbing,Sign, WW Ftirnaro'.Boilers,Hewers,
T.nks.t Condi6.ti9.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR V"ROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
IMsbbyycer*tialhavereadamlesaminedthis icationamiknowthesametobetrueatdcrosect. Allprovvioru oflaws and ord'natuesgovernirg thb
type ojwork will be complied with whether apeci ed herein or not. The grs ming of a permit does not tweam a to gone authority to violate or carrel the
provutwu ofarry otherfederal,state, or local(aw regulating combustion or the performance ofcaast io uhm.
Signature of OwnerXe�"" ,�qq--." - Signature Of Contractor
..... ..... .. .�1.... -- Print Name mAs SX✓�--_
Swoon to a rN SHORE Sworn to and subscribed before me
this 20 this, Day of 70. 0
•FF 074;21 junulF
Notary Pu is ': i urco4il
exviaes. s .
::�j mMremn,rwntweum.�•n .. . ... ... ...
NOTICE OF COMMENCEMENT
State of r 1 County of EJ�/ Ufi� I Tax Folio No.
To Whom ItMay Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in rs NOTICE OF COMMENCE1NT.
Legal Description of property being improved: 3 F�'
f v 33
Address of properly being improved: cS ff _ � oIJ7et fo G /'-f .)-2-3
General description of improvements: C�zU d)
Owner: itans wh,'}t Address:310 6itV�r Rol ,,li9 1&)k✓C fffl c ,F9,32s73
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
mos Azp
Name: O c 5 3 x
a oze; gx
Cgntmctor: -A-It Gn Gd- o I
„ Address: Ric v"ern y&-k Rd -37 the PSIs%f, /-1 324170 I��
Telephone No.: 2- Fax No: 8 x2�p
Surety(if any) o' m
Address: Amount of Bond$ F
Telephone No: Fax No: 3
Name and address of my person making a loan for the construction of the improvements A
y
Name: o
< w
Address: n
Phone No: Fax No:
Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(6),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
�/
Signed:
Before me t�_f I day of in the County of Duval,State
„c Of Florida,has personally appeared
" PAMELA JEAN SNORE Personally Known: or
Notary Public-State of Florida Produced IdentificaY
ae` My Comm.Explicit Dec 1,2017 Notary Public:
rv�•••
Commission•FF 071537 My commission expires:
4 FF 0-7 '153