1085 Atlantic Blvd Bldg 7 2012 roof .I CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001142 Date 8/30/12
Property Address . . . . . . 1085 ATLANTIC BLVD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 17600
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Application desc
REROOF BLDG 7
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Owner Contractor
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_
1085 ATLANTIC LLC PERFORMANCE ROOFING LLC
5118 N 56TH ST 2235 MERCATOR DR
TAMPA FL 33610 WINTER SPRINGS FL 32807
(4 07) 373-9543
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 140 . 00 Plan Check Fee 00
Issue Date Valuation 17600
Expiration Date 2/26/13
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Other Fees . . . . . . . . . STA E DCA SURCHARGE 2 . 10
STATE DBPR SURCHARGE 2 . 10
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Fee summary Charged Paid Credited Due
-----------------
- ----------
Permit Fee Total 140 . 00 1140 . 00 . 00 . 00
Plan Check Total 00 . 00 . 00 . 00
Other Fee Total 4 . 20 4 . 20 . 00 . 00
Grand Total 144 . 20 144 . 20
. 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH AL1, CITY OF Al LANTIC 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 9
Job Address: 3zz33Perm it Number:
Legal Description -a!�-aRE L 3r74 o E,ar+ Par el #
Valuation of Work$ ' - oar tea a q. t• , Q ,t
Proposed Work heate /cooled —r non-heated/cooled
/76, 0 ?w-c2'o1r7 % R roo6 e; 5r tmk 1Z-001b s1CS�ari,
Class of Work(circle one) NeNA, Addition Alteration Repair Move Demolition pool/spa windoNv/door
Use of existing/proposed structure(s)(circle one): Commercial Rcsidental
If an existing structure, is a fire sprinkler system installed? (Circle'one): es N/A
Florida Product Approval # F L '
For multiple products use product approval arm
Describe in detail the type of work to be performed: �Q _.� A O Q5
� �_ �•eAk•d� x'17-•-,cG�oss
Pronerty Owner Information•
Name.- NAS A'1 c.,I•''G`. C
.__. �_.�_.._......_.._..__.___Address:
City 7T ods
---- `^� _ ._ Stater--L-Zip 3 3byQ-- al
-Phone ,.._..
E-Mail or Fax# (Optional)_
Contractor Information:
Company Name:.- r�gM{� Quali, .mg Agent: ,Ak,
Address: ota3flLIh T_i(Z?R, -_ _ , 7i 32 a
Office Phone X04 z 1 o L 5-n 3 Job Site/Contact Number& _ 59'6-95 4 3 _ Fax# p __2._.__
State CertifieatioiVRegistration#_<s _G a;qq 3�1 35 `A' 3
. _
Architect Name & Phone# - --- ------
Engincc;r's Name& Phone�# — ----
Fee Simple Title Holder Name and
Bonding Company Name and --
Mortgage Lender Name and Address
Ipliii<atlu)t is Ilc+re>hv))rc)il:�to uGu)i))a p,;T to do the 14'0)%fu>r1 iustgllf)rifNrs as ixfl/c )tcrcl. l cer ifL'drat)to 11w/t or installation lots eommenced•prior to the
i,YSrlflllC<> f a!)ei7lfil a/!tl that/air x`O) k'!!I be pe)fOJT)lC.d t0lnel:t thf>.t'tf111llfrr"'a)ff/l1 lt/1'.S)Yfl,..ttletlr)tG Cf,N),1i117fCt1t?71 i)t I111S)n1T.ShcCtr01). 7hiS pe17)li!ht conJ<>,r Hall
tnld vattl rf►Ittt�e tS/JAI C'antntt')Je'ell IPlfhln SJ.0(Gf nJ0)lth5', U)'1f C't)llstt7lf tft)!r o)'11't)tA Is'-1]
s. is a/lalr'tl tlrc)handuttcri fur C)p�er/nd oJ.ri.r�Gj months Cfl a1tL'flnJB Clflc)'
I,wk is ctainrmelrrert I ruuletstanfl Ilial separate pernrits nrrrst h1>sea.'nttl lr)/ hlec7tti f tf ark, Phombing.,Vijily, N ells, Pools, Purnaces, Boilers, Healers,
1fmt:s aNrl t/r G'rrndGtium'rti•,cats:
WARNING TO OWNER: YOUR FAILU E TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR P YING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO O TAIN FINANCING CONSULT WITH
YOUR. LENDER OR AN ATTORNEY BEFORRECORDING YOUR NOTICE OF
COMMENCE ENT,
I hereb certify'thanhal'e read a)rd a ranritleal this ar ptic•arrarr andlinux`they sante r0 be,l ane:a)ul convet :IiI prrn'isr'vlas OfIa11'S alltIOlYIli1C/11C'L'S governinx this
o/Yilrork will be complied with udret/rer s rt reflllr.)t"in ur.nal. The Kttttrti))� c1/a pernti/alve>s nut p)est/nte to Kine arrtlrori�v to violate or cancel the
provisions gfalw otherfederal,state.or I(x•al lux°tt'gulating consintctiun an Ilte pel fu) rcn)ce gl`consltttction.
Si4;11ature of O,N net Si I
- natttre of Contracto
Print Name B r")ol2s � /
Pn t Name ,,, _rk7 K >~
Swtirn td and subscribed before:me SNv' rn to and sul)scr'bed before me
thi " '%Day of 20 l�-
thi a`� Day of 207-
ROBIN
ROBIN S WILLIAMS MARY JO FRETZ
otary ub is .9 ary Public-State of Florida O ary ht tC
3 _
sh .=My Comm, Expires ne,. , c STATE OF LORIQA
�jFo�,d?`Q,' [•r,�r;,,,,�, C�hM EE019456
Expires 8122I2014
NOTICE OF COMM]
State
Tax Folio No.
County ofTo Wham It May Concern:
} ccrl.
The undersigned hereby informs you that improvements will be made to I certain real propert}, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in tlus NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 3% -aS atj ,&b Y Fr
Address of property being improved:
General description of improvements: aye,
Owner: Address: 11
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):_
Name:
Contractor:3�n F
Address: ;;Q15 t. 3 z 09 _
Telephone No.:�{D n .Z10, 15�3 __.. Fax No:
Surety(if any)
Address: _ Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the constriction of the i' Doe#2012187521,OR BK 16053 Page 654,
Number Pages: 1
Name: " Recorded 08/30/2012 at 02:22 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
Address:._____._ COUNTY
RECORDING$10.00
Phone No; Fax No:_
Naive of*sots within the State of Florida, other than himself. designatedby owner upon whom notices or other docmnents may be
served: Name:
Address: —"
Telephone No:_ Fax No:
In addition to himself, owner designates the following person to receiv, a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Y� Fax No:
Expiration date of Notice of Commencement (the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS CE FOR RECORDER'S USE ONLY OWNER —
ell " Si�n�c1: . _ � `/� Date: _3a ,�
Before ine t is c�� a of_ �
--� Y ._ ��J_.�in the County s= o[�Duval,
ROBIN S WILLIAMS State
OF Florida,has personal] appeared
£ Notary Public•State of Florida NotaryPublic at Large,S to of Florida,County of Duval.
MY Comm.Expires Dec 13,2015 My commission expires:
„u `G•r`� Commission#EE 145624 Personally l(nown: --- -or
Produced identitication: �� —