1057 LITTLE CYPRESS KEY - ROOF ,�S �,''{r � , CITY OF ATLANTIC BEACH
1 -::.- J 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-3668
Job Type: ROOF PERMIT
Description: RE -ROOF
Estimated Value: $13,789.00
Issue Date: 4/4/2017
Expiration Date: 10/1/2017
PROPERTY ADDRESS:
Address: 1057 LITTLE CYPRESS KEY
RE Number: 172027-5830
PROPERTY OWNER:
Name: NEUBERG TRUSTEE, CARL E
Address: 1057 LITTLE CYPRESS KEY 1057 LITTLE CYPRESS
KEY - -GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY ROOFING CORP
, CCC1325973
Address: 5018 SPRING PARK RD STE 2 CHAD DAVID BELL
Phone: - -
FEES:
BUILDING PERMIT FEE $118.95
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $122.95
PERMIT IS APPROVED ONLY IN ACCORDANCE WTTII ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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J'PMorgan Chase 3/30/2017 8:07:54 PM PAGE 4/006 Fax Server
BUSING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
• 800 Seminole Road,Atlantic Beach,FL 32233
O lice<904)247-5826 Fax(904)247.5845 ` -7 r� }�-
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Sob Address: /S
• �S Permit Number:
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Legal Description .. . . ..-•_.. --i` of ; ..../ . .L L _or 1 • /. wu.kc;i.•t
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Valuation of Work$1� •Q Proposed,Work b.e ted/cooled moa-heated/cooXet'lt, •
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Class afCVorlG(circle or�p): eAcl itort Repair M• •rtnolition pool/cps Yvfndor/door
USC of existfngJp roposeci'stzuctuxe s cr�cle este): Commercial lidentiul
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Desctx'bc in detail The type of work to be performed: 1 _.
an c 4 !nerInform2tion:
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Compat:,y Name: !ilk" Gi
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03/31/2017 08:06 5042680660 SIGNATURE REALTY PAGE 02/02
JPMorgan Chaco 3/30/2017 8:07:54 PM PACE 6/O0G Fax Server
CALIFORNIA JURAT WITH AFFIANT STATEMrNT GOVSRNh18NT CODE 08202
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Signature of Document Signer No. I Signe • of Document Signer No.2(lf any)
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Stele of California �, ,, Subscribed and sworn to (or affirmed) Worts me
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