Permit Folder 307 309 4th St CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
'} = ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000003 Date 1/05/10
Property Address . . . . . . 307 309 4TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8000
----------------------------------------------
Application desc
REROOF 10134 . 10
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Owner Contractor
------------------------ ------------------------
PESTERFIELD, J.D. H&K ROOFING
307-09 4TH STREET 1540-8 MONUMENT RD.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 642-5100
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date Valuation . . . . 8000
Expiration Date . . 7/04/10
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Fee summary Charged Paid Credited Due
--------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
i
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09-
CITY OF ATLANTIC BEACH
Date:_ �Q�(' ROOFING PERMIT APPLICATION �L �qgZ�-0OX
_ � �"
Job Address: 5 o-z `• 30c, >k'
Owner of Property: j ' h/"A5_LT\
Address: _30 `J�---- 2' Telephone: �'►t R 1+ 1`� —
Roof Contractor: d � L State License Number: (/(,( 01"N7�
Contractor's Address:
z7
Telephone: Lq0q/ A-4100
Fax: qoT�&Z Z_L( Email:
Scope of Work: ('� `�t ( 1 9• ( ( Z� V, j� J
p Q'N I ! �� L�I LY CQi (� u Roofing Material
FL Product Approval# d ( ✓�[ . �(,/ Valuation of Work: $ S,000,
Required Inspections: Sheathing/In Progress-Dry In /Final
If re-roof: Assessed Value of Structure:/<$300,000/_>$300,000;Roof-to-wall improvements required?
(Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE I THY FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTOR V BE E RECORDING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER: Date: (
AS TO OWNER: '(I�•
Sworn to and subscribed before me this `1 w day of 20_10 .
State of Florida,County of Duval
Notary's Signature: �rl w>^.
❑ personally known
U-Produced identification ` '
Type of identification produced L.notary Public state of Florida
nrr-Nemrflett
�yL...� ,�a� Ex Commission D0690812
SIGNATURE OF CONTRACTOR:
Date: I t I"�' t � c„�,d" Expires 08/28!2011
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 20
State of Florida,County of Duval
Notary's Signatur
rersotially known
❑ roduced identification 2q.�10 q� Notary Public state of Florida
Type of identification produced Dana Hammett
c n D0 90812
'}or Expires O,a/28l2011
800 Seminole Road•Atlantic Beach,Florida 32233-5445 +°a.IS ^,^
Telephone: (904)247-5800•Fax:(904)247-5845
F:\roof permit applicaton.docx 7/28/09
` NOTICE OF COZVIMENCEMENT
(PREPARE IN DUPLICATE) f�
Permit No. Tax Folio No. V t ii-11q Coe)()
State of vt ca. County of_ `_htk L
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 of the Florida Statutes,the following information Is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
Address of property being improved: v
General description of improvements: YXtC�
Owner �I
Address dW ' _3-3
Owner's interest in site of the improvement O vw 0 CLh
Fee Simple Titleholder{if other than owner) Y-Tj .,C--
Name
Address
Contractor
T) ;,t Address t C p OViu tnacrt�" V-i
Phone No. -1(M,1 Lp"42—S-loo Fax No.__1otij
Surety(f any) _
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name %A�
Address
Phone No. Fax No.
Nam of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may a served:
Name V N�"
Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienoes Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name --
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is oF (1)year from the date of recording unless a
different date is specified): i'
THIS SPACE FOR RECORDER'S USE ONLY � OWNER
S' 4AIIzaDATE
Doc#2010000895,OR BK 1611,5 Page 1 ii 1, Before me dbq Cover veal of F of h in the
Number Pages:1 �S bila
- M . °M_tT red m
Recorded 01/05/2010 at 08:09 AM, himself/herself and affirms that an statements and decla ion49[r* Notary Public State of Florida
JIM FULLER CLERK CIRCUIT COURT DUVAL are true and accurate r° "cif Dana H?mmptt
COUNTY �o* My GO•n`+nrssn+1, D0690812
1 e�
RECORDING$10.00 �'�r K�* Expires 0er261201 t
Ne
Notaa Public at Large,Slew of
My commission expires:
Personally Known or
Produced Identffication a °,