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366 Skate Rd 15-RAAR-2741 °s, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 lilt RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-RAAR-2741 Job Type: RESIDENTIAL ALTERATION Description: FLOOD REPAIR - FIRE WALL Estimated Value: Issue Date: 11/24/2015 Expiration Date: 5/22/2016 PROPERTY ADDRESS: Address: 366 SKATE RD RE Number: 171664-0000 PROPERTY OWNER: Name: BEAUFORD, LEROY Address: 366 SKATE RD PERMIT INFORMATION: FEES: Total Payments: $0.00 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 1 -5 -- R A R R_Z 74 Job Address: A--cc ( Permit Number: Legal Description Parcel# Valuation of Work� oor Area o q. t. t Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proosed structures)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approva orm Describe in detail the type of work to be performed: r— L C)© p Property Owner Information• '�oc-� Name: � e i`o�4 �P Q� Address: City State_Zip Phone E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: Qualifying Agent: Address: City Office Phone Job Site/Contact Number State Zip State Certification/Registration# Fax# 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 is herereby made to obtain a permit to do the work and installations as indicated. I cert fy thatruno tlowork or installation has commenced prior to the and void work stnot commenlced tiv thinl b (6)fm nthst omif construtot:onror ork is suspr e�ded o�abandoned for a p=e i'od fsixn6)mon hs at aneCtime after work is commenced. 1 understand that separate permits must be secured for E[ectricat Work,Pkrmbing,Signs, iVells,Pools, urnaces,Boile s,Heaters, Tanks and Air Conditioners,etc. 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 YO'UR NOTICE OF COMMENCEMENT. [here certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this ape glYwork will be complied with whether speci ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of arty other federal,state, or local law regulating construction or the performance of construction. >ignature of Owner Signature of Contractor 'rint Name .........................................................................................__. Print Name .......................................... ...................... ............... ......................................................-_..................... i Sore me a of Before me Day 20 this Day of V 20 rotary Public Notary Public I Revised 01.26.10