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Permit 872 Amberjack Lane CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000236 Date 3/04/10 Property Address . . . . . . 872 AMBERJACK LN Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3882 ---------------------------------------------------------------------------- Application desc REROOF SHINGLE ROOF FL PRODUCT APPROVAL 5444 . 7 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCKENZIE JEROME & CHARLENE PERFORMANCE ROOFING LLC 509 CAMELIA ST 2235 MERCATOR DR ATLANTIC BEACH FL 32233 ST. AUGUSTINE FL 32087 (407) 210-1503 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 3882 Expiration Date . . 8/31/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH SS 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 �M X33 It Application Number . . . . . 10-00000236 Date 3/04/10 Property Address . . . . . . 872 AMBERJACK LN Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3882 ---------------------------------------------------------------------------- Application desc REROOF SHINGLE ROOF FL PRODUCT APPROVAL 5444 . 7 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCKENZIE JEROME & CHARLENE PERFORMANCE ROOFING LLC 509 CAMELIA ST 2235 MERCATOR DR ATLANTIC BEACH FL 32233 ST. AUGUSTINE FL 32087 (407) 210-1503 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 3882 Expiration Date . . 8/31/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 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 Job Address: L----Q- Akk--k+c- (3wJ- FL- 32.Z33 Permit Number: '122 v Legal Description 3o-L0 38- 23-MkC 2:23,< «,r, uo�,+al Parcel# t-1 t1,lto -Dom Valuation of Work$ 3,$f 2•�� Class of Work(circle one): New Addition Alteration RePai M emolition pool/spa window/door Use of existing/pro osed structure(s) (circle one):. Commerclaesidentia If an existing structure,is a fire sprinkler system installed? (Circle one): es o N/A Florida Product Approval# '514414 71 For multiple products use pro uct approval form Describe in detail the type of work to be performed: c- r� e_F Property Owner Information: Name: "Serooe.[Ctnnrlt^a- Address: 817- City ?ZCity Al-ta,it. %3uoh Statef Zip 32-233 Phone c-lEt- 33Kg E-Mail or Fax#(Optional) Contractor Information: Company Name: Qualifying Agent: R,.,_ u A 440;t-&S Address: 22 I5 M ercoi%r On- City orlon'- State FL Zip Sao-) Office Phone Uz-)- 2to- iso3 Job Site/Contact Number Fax# 3u- 2z1-�1�3 State Certification/Registration# Cec. os'7 `54 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 hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a perod of six 6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, furnaces,Boilers, 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 YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state,or local law regulating construction or the performance of construction. Signature of Ow r Q1'YU 1G M�((l Signature of Contracto Print Name Print Name Sworo an subscn d before me Sworn to a subsc 'bed before me this f'� D of PIAR5 { , 20 l� this 2S y Qt 2010 No b c Notary-Puliji ASHLEY VINSON ASHLEY VINS%vised 01.26.10 NNOTARY PUBLIC NOTARY PUBLIC STATE OF FLORIDA STATE OF FLORIDAm Comm#DD0925944 - Com#DD0925944 w.:.,,' Exr*es 9/16/2013 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. State of Florida,County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 1. Description of property(legal description of property and address if available): ' 30-Leo 1,9- 23 -Zit E U,44- t 2. General Description of improvements: Q.e-rwF 3. Owner Information: a)Name and Address: 'Sore"A( C t"rle_e {4.ae sZ,c- in 2. ktjocAroc _ "s- 3 2233 b)Interest in property: c)Name and address of simple titleholder(if other than owner): 4. Contractor Information: a)Name and Address: Per2235 #Aerc•t•r bL Or" FL IWO b)Phone Number: LAu-1-zt0- ISo 3 5. Surety Information: Doc#2010048598,Gil BK 15171 Page 53, a)Name and Address: Number Pages: 1 b)Phone Number: Recorded 03/03/2010 at 12:25 PM, c)Amount of Bond:S JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY 6. Lender Information: RECORDING$10.00 a)Name and Address: b)Phone Number: ---—----- --- — 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13(1)(a)7,Florida Statutes: a)Name and Address: b)Phone Numbers of Designated Person: 8. In addition to himself/herself,Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. a)Name and Address: b)Phone Number of person or entity designated by owner: 9 Expiration date of Notice of Commencement(The expiration date is one(1)year from the date of Recording unless a different date is specified: WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING NOTICE OF COMMENCEMENT. , Y , "Al :a Yvan I Si natu of Owner or Owner's AuthorizeA O icer ect r/Partner/Manager Signatory's Printed Name&Title/Oftice The foregoing instrument was acknowledged before me this�—day of 20_10 by � � 1 'it�2ie�i f (Name of Person) (Authority Type,i.e.Officer/Attorney) (Name / Party Instrument was Executed for) ASHLEY VINSON ( NOTARY PUBLIC NOTA Y PUB I STA`T,EE O-FF FLORIDA STATE OF FLORIDA Comm#DD0925944 Print Name: E>�ines 9/16/2A13 r Personally Known )<,Identification/Type: Verification pursuant to Section 92.525,Florida Statutes. Under penalties of perjury,I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. Signature of Natural Person Signing Above Revised 10/1/2009 HP OfficeJet 7410 Log for Personal Printer/Fax/Copier/Scanner Information SystemsCiTY O 904-247-5845 Mar 04 2010 11:43AM Last Transaction Date Time Type Identification Duration Pages Result Mar 4 11:43AM Fax Sent 913212391973 0:26 1 OK