306 2ND ST - ROOF PERMITs, CITY OF ATLANTIC BEACH
9 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
2\ INSPECTION PHONE LINE 247-5814
0,319%'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2118
Job Type: ROOF PERMIT
Description: reroof FL 10124.1
Estimated Value: $6.500.00
Issue Date: 9/8/2015
Expiration Date:3/6/2016
PROPERTY ADDRESS:
Address: 306 2ND ST
RE Number: 169757-0010
PROPERTY OWNER:
Name: MORTON ET AL, WILLIAM K
Address: 961 LEW BLVD
GENERAL CONTRACTOR INFORMATION:
Name: D & S ROOFING OF N. FL. INC.
Address: PO BOX 1986 QA RANDALL SCOTT DRAWDY
Phone: - -
FEES:
STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
BUILDING PERMIT FEE 82.50
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
State of /14" County of pfoY19 L Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 oftheFloridaStatutes,the following information is stated in this NOTICE OF COMMENCEMENT.Legal Description ofproperty being improved: /4/04/4,77 C /33/90 /t/ ea '' dr- L U l 3i: 3 o// ificax c' 7 --/o 97 0-AS
Address of property being improved: 50-g Gez 0 57/7 ic
General description of improvements: /26" ,240'17:
Owner: WC(/44i fvlonrotv Address: 2 l//EJo Sr s% iT 'cr- /LC- 520511
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: OS 14.0 K# i+.r/ Arf SKCC .
Address: el 4 .2 r3 3)a5v
Telephone No.: f)Y/ .2 ll'4' 7663' Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: 42—
Address:
Phone No:Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may beserved: Name: a--
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section713.06(2)(b),Florida Statues. (Fill in at Owner's option)Name: 0_
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date issnecifiedl-
Doc#2015206179,OR BK 17294 Page 2437,
Number Pages:1
OWNERRecorded09/08/2015 at 02:27 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY Signed:
Date: / 'Of 24,6-RECORDING$10.00 Before me this ca day of aeAbtio- in the County ofDuval,StateOfFlorida,has personally appeared GoI/CC/i Zvi ,idRr0/VPersonallyKnown:
Produced Identification: FL 1G, 0, •
or
r ^
oof
o Notary Public State of Florida Notary Public: i ONancyEBaileyMycommissionexpires:J My Commission EE 156116
or Expires 02/08/2016
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: i4 /3f SEC'."0 Sj Permit Number:
f 304 #Legal Description 9-,C/1 A/f 1°75 1,3 el
Valuation of Work$ vp
Floor Area of Sq.Ft. tProposedWorkheated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move demolition pool/spa window/doorUseofexisting/proposed structure(s) (circle one): Commercial esidenti.%If an existing structure,is a flit;sprinkler system installed? (Circle one): - • N/AFloridaProductApproval # 'l . /Oi/, ii.
For multiple products use product approval form
Describe in detail the type of work to be performed: RC /earlT
Property Owner Information:
Name: & i 1 dl27 */v/C1aAddress: Z S%City 5% 40 State .Zip 32-at' Phone 9Oy BOG- / gE-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:a44'e cf.S MY1!<lee.I C/"-ICompanyName: 00S I /l CGH ` cQ'i(rte Qualifying Agent: f HZ-'/19 QAddress: 3`! V• 2 City V—Office Phone 90 K 4 VG 766$' Job Site/Contact Number a
State Zip (
State Certification/Registration#GGC' 1 S . gv?v 3 (
G GAO p Fax#
Architect Name&Phone# J4 '
Engineer's Name &Phone#WAFeeSimpleTitleHolderNameandAddress 4BondingCompanyNameandAddressi
Mortgage Lender Name and Address A/
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 theissuanceworkislnotcommencedwithinlsix
performed
6) onths,
t
ortifconstruction or
of
is suspended
B or abandone idfor
ahlejurisdiction.
iod ofs 6)Thismonths attanytime afterworkiscommenced. I understand that separate permits must be securedfor Electrical !York, Plumbing, Signs, Wells,Pools, Furnaces,Boilers, Heaters,Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OFCOMMENCEMENTMAYRESULTINYOURPAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITHYOURLENDERORANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT.
I hereby certify that I have read and examined this a placation and know the same to be true and correct. Allprovisions oflaws and ordinances governing thistypeofworkwillbecompliedwithwhetherspecifiedhereinornot. The granting of a permit does not presume to give thority to violate or cancel the9rovisionsofanyotherfederal,state, r local law regulating construction or the performance ofconstruction.
signature of Owner g
Signature of Contractor _ ,/
rant Name 10/1C"4,le` M o emit,
Print Name c
lefore me C B .re Ileits_Day of °_e r 20 f, t ils _'D. . of_ r'.'r5_..a Public State of Florida20
lotary Pub'c• Notary Public states !odds
Nancy E Bailey Notary Pu:is Y.•
1-. I My Commission EE 158118 MOP Revised 01.26.10or^ Expires 02/08/2016