1852 Hickory Ln re-roof permit SL51Pl j�,
CITY OF ATLANTIC BEACH
a
800 SEMINOLE ROAD
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-3279
Job Type: ROOF PERMIT
Description: RE ROOF SHINGLES
Estimated Value: $14,546.00
Issue Date: 2/23/2017
Expiration Date: 8/22/2017
PROPERTY ADDRESS:
Address: 1852 HICKORY LN
RE Number: 172020-1454
PROPERTY OWNER:
Name: White, John
Address: 1852 Hickory LN
GENERAL CONTRACTOR INFORMATION:
Name: K & D ROOFING & CONSTRUCTION
Robert Hile,CBC1258249
Address: 2758 DAWN RD SUITE 1NE QA ROBERTANTHONY
HILE
Phone: -
FEES:
BUILDING PERMIT FEE $122.73
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $126.73
PERMIT LS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BOLDING CODES
-- BUILDING PERMIT APPLICATION
CTPD OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,Fl,32233
Office(904)247-5826 Fax(904)247-5845 17- Fl p F- 5 z 79
Job Address: I Sa Nir ke=4Lm la+l Bci, 31 Permit N er: k 17837550
i�Plat �'7
Legal Descriptio '29 •cl$•�� o IYlct�inaZlnii� Paroel# I ZOzO' 1454
9• F —Sq'.'F�—
Valuation of Work$�,SyL_ C Proposed Work heated/cooled�Q1 non-beated/cooled__qaoL
Class of Work(circle one): New Addition Alteration <5D Move Demolition pooltspa window/door
Use of eAtio g(proposed strvcture(s)((mrole one); Commeroial idential
If an coasting structure,is afire sprur&ler system installed?(Circle one): es o
Florida Product Approval# L
For multiple products ase pro uM approve arm p
Describe in detail the type of work to be performed: RQ Rte 5091,
Property Owner Information: 1
Name: j6kn 1116i�e Address l�pn2
CiTy R3+L_+1c O+.^- tr+ Stam}IZip !A Phone qo4. 383• '70Q
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: r LCoF+,yr..eF:en •Qualifying Agent:
Atldress:'j4 tyti 5k.S.G..:.. _ " City .3ex. Bc!•,. State j_zip 31.ZS0
Office Phone 4• O Job Site(ComsctNumber Fax#
State Certification/Regishation# CM 13Q595'a_
ArchftdName&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage lender Name and Address
Applicmton w hereby made to obmin a permit to do the work and iovdladore w indirmad I cemfy that w work or wtollation has com,,omodprior to the
Osuance apermtt andthx aRworkwdJ 6e%ormed to mest the rtandards ofa111aws regulating comIrRadon b,dosjwisdi000n Thvpermitbecomesmdl
andwid workw ocommenmdwfthfnsfs(6Jmoxhr,or tJ'conmvcHon arworkls nded or abaMorredforappeerzod ofsis//6)moxhs at g titer
work S commersed I understand U,x separme permttr Horst be secwedfor EltWork,Pbrmb(ng,SYgv, W le/tR PootR Fivnaaea,Bo cal
Tonka atdAi,ConAtlo.,xc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR BUROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOM NOTICE OF
COMMENCEMENT.
lherebvicert Matlhovs.tidatdezmnfrwddu't�plica<Ian odknmvlh,saowwbs Cveandcorrect Allprovirimu o(Laws and ordGm�cee governtr�q dds
type oall work will be co l@d with whedrer syr Md/vein or not Tfie grmrttng of apsrndt does not presune to ghe mvharity to violate or tante!the
provrnary ofany otherfe d. e,or Jocal aw gulxmgcotutucn'onortheperformanceofaronabuc m
lot Signature of Owner Signature of Commetor 06 �
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Sworn to and subscribed before me Swo to and subscgbed before me
this Da fy_o Jar,uery .20 1'•7 i/his� Day of . 10nunru 20 lel
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Doc Y 2017035649, OR BK 17877 Page 1590, Number Pages: 1, Recorded
02/14/2017 at 12:29 PN, Ronnie Fussell CLERK CIRCUIT COURT UDVA COUNTY
RECORDING $10.00
NOTICE OF COMMENCRMEN•r
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