735 BONITA RD - ROOF rS - lj -
�" � ``- S, CITY OF ATLANTIC BEACH
_ _ j, 800 SEMINOLE ROAD
6 ATLANTIC BEACH, FL 32233
\ —� INSPECTION PHONE LINE 247-5814
' ---z_._.:-0.2191-'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ROOF-3446
Job Type: ROOF PERMIT
Description: re-roof FL1956 & FL21350.1
Estimated Value: $3,445.00
Issue Date: 3/9/2017
Expiration Date: 9/5/2017
PROPERTY ADDRESS:
Address: 735 BONITA RD
RE Number: 171137-0000
PROPERTY OWNER:
Name: HARRISON FLA LLC
Address: 3500 SOUTH DUPONT HWY
GENERAL CONTRACTOR INFORMATION:
Name: EXCEL ROOFING CONTRACTING
Henry Scott Sorensen, CCC1328406
Address: 5722 DUNN AVE HENRY SCOTT SORENSEN
Phone: - -
FEES: -- -- ---- -----
BUILDING PERMIT FEE $67.23
STATE DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $71.23
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
,lob Address: 73,,S'& jq xa IlyatTie44,4 it J2.13 Permit Number: 11 9,00 P.-Y-1(4k)
Legal Description !o-i II-25-'2170.0 a��!}ill 1-_01-C0f
ns aivit -C 8, arcel # /2/),:32-Q[Z"1
Floor Area_ of Sq.I-t Nq.1-t
Valuation of Work S .3, 5.CV Proposed Work heated/cooled non-heatedicooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooL'spa window'door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire spnnr system installed?(Circle one .i.) N /A
Florida Product Approval # /9.5.'‘ Vi y)-0( y►s,-r-u-t tom- 2'•133c)• t
For multiple products use product approval orm
Describe in detail the type of work to be performed: R�!4W7e - 3.h,'i?i• i -_
Property Owner Information: 1
Name:_&ti i on /•:
Address: 2 Gc)SGald IA�/1 L 11 ll�+y!
City firer _----____-,State ip JgLPhone 51 -tel '.?_
E-Mail or Fax#(Optional)
Contractor Information: /
Company Name:. ..' . ..o, 4,.. __._Qualifying Agent M fnt j 2 ; I
Address: �--7 2.2 'I _ City ..,�LtKs;vrty ll,4;_ State a Zip -49.90
Office Phony 4, .rS l Job Site/Contact Number L-1 )yak Fax# 214/-owed
State Certification/Registration# L
Architect Name& Phone i; 4/1/
Engineer's Name& Phone#_._,//,,___-
Fee Simple Title Holder Name and Address.ly,
Bonding Company Name and Address fy, .
Mortgage Lender Name and Address Aye¢
Applicationu ay*to obtain u permit to do the work and installations as indicated t certify that no work or instal ation has commenced prior to the
issuance 4[a And*as all workwill be pe ormed to meet the standards of all laws rejulating construction_in this jurisdiction This permit becomes null
and void c" $teor ed within six Of months, or if construction or work is suspended or abandoned for a period of six rbi months at any time after
work is commenced �med that separate permits mast he secured for Electrical!York.Pbuwblag Signs, Wellx, Pools, Fanfares. Boilers, healers,
Tanks and Air Condlllmll an
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.
' 1 hereby certifr that I have read and examined this application and know the same to he true are!correct. All provisions of laws• • minces governing tins
two ofwork will he complied with whether specified herein or not. The granting of a permit does not presume to gt • ,to violate or cancel the
provisions ofany other federal,state, or local(ow regulating construction or the performance of coastrus;tion. /
l'e
Signature of Owner (f�� _ _ --_ Signature of Contractor ' ,. -- --
Print Name �� ,,/3 r!"e!%j4 Print Name ' .,L�
Sworn to and subscribed before me Sworn to and subscribed before me
this_ ' Day of -a1 Art r rf , 20l 7 this _ Day of J1gn ,20/2
/�, ---
'-a-....� _FRANCIS.CANAAN° r 1W .r_. //i/ /I-
No Public '4otary •t '•''r""'
11 � � STATE OF NEW YORK
NOTARY PUBLIC ••,s, .',,,•�••,,,, DENISE LYNN TAIT
ID 01 CA6332931to7t, Notary Public:Stay of Florida
EXPIRES 11 09 2019 ' • • Commission 4 FF000169
BRONX COUNTY %�q.'•"•' My Comm. b Natio Jul tar7.2020
ss,
.aa flondsd tArouyl►National Notary Assn
4
Doc # 2017053072, OR BK 17901 Page 798, Number Pages: 1 , Recorded 03/07/2017
at 12:47 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
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