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Permit 1644 W Park Ter CITY OF ATLANTIC BEACH 11 800 SEMINOLE ROAD =N ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000243 Date 3/04/10 Property Address . . . . . . 1644 W PARK TER Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 12500 ------------------------------------------- Application desc reroof ------------------------------------------- Owner Contractor - ------------------------ ----------------------- HARDMAN, CHARLES AAA ROOFMASTERS INC 1644 PARK TERRACE WEST 2446 TYSON LAKE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 639-8766 ------------------------------------------ Permit . . . . . . ROOF PERMIT Additional desc . . . 00 Permit Fee . . . . 115 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 12500 Expiration Date . . 8/31/10 ------------------------------------------------------------- Fee summary Charged Paid Credited Due ----- ---------- ---------- Permit Fee Total 115 . 00 115 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 115 . 00 115 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 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): 2. General Descri tion of improvements: 1r. (� 51 mac.ins 3� � E� 3. Owner Information: j� y P N�� ������ yd 3)'X33�a 3 3 a)Name and Address: H`Pn n C� 0"dMM, I b)Interest in property: c)Name and address of simple titleholder(if other than owner): 4. Contractor Information: a)Name and Address: A�N- IZ-oyfNl14 S"(CO- 1�N C 3 �fo Y" b)Phone Number: x;04 It-!p w?(o63 4x` Surety Information: Doc#2u i uub00ri s,O R b K i b i j t Page.i bet), a1 Name and Address: Number Pages: 1 — 1 Recorded 03!04;2010 at 03:10 PM. b)Phone Number: „IM FULLER CLERK CIRCUIT COURT DUVAL c)Amount of Bond: $ COUNTY RECORDING$10.00 6. Lender Information: 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 I, 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 YOUR �1i&;pMMENCEMENT. 4f '''' ign of Omer 'vale s Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office 2V i Ivo ,a The fof� it .3 � f& as acknowledged before me this�S'/"day of , 20 0,by �� lAvE ,•` as for K� ��� ame of Person) (Authority Type,i.e.Officer/Attorney) (Name of Party Instrument was Executed for) 1� rim CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 10- OFFICE:(904)247-5826 a FAX NO.:(904)247-5845 VWM.COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 'a ,WDR '2 Pqt- IV/kf-* I S89' — W4 DIESQ131IRTIONWEV10 r t R:r Aftg* taS Sr,0 F.VVOR K4 " ST -T 0 NEW BUILDING 11 DEMOLITION 2kESID0-L - LOT BLOCK—SUB DIVISION 11 ADDITION El CONVERTING USE 11 COMMERCIAL 13 ALTERATION 11 ACCESSORY BLDG. e's F)RE�Sf RINKLEWPOW —1b'xg- 13 REPAIR OPOOL/SPA 0 YES 1-1 NIA 11 MOVE 11 OTHER 13 NO .1 PR011?,ER.Y OWNERESM,N- Itah -A*,*.X4 -1311" '-'V* 9 -M*WffAR f 411 ,T ,EQT: ENGINEER' 07,fW 0 10 1,W QW40 .0�,PONTMPT 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: /1,N& I 200 r-/,\,I a S 1-,r fl-r C, 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: 17.STATE OF FLORID LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: Lf L4 I,- r-rre-",r-e- L- C cc- 11-1-Z0 34/ 1B.ADDRESS: 3.1so e,,crs.� 5�- 26.ADDRESS: Zx 11.OFFICE PHONE: J.9.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 1906 63 f 9 7 G(. 66 -7 13.CELL PHONE: 21.CELL PHONE� 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: no=SIMPLE iT]XL",OLDER,1AW WguP ,BONDING NV "M' GAGE L W- W" ogOL 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 135,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 period 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, Air Conditioners,etc. OWNER'S AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning.I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: YOUR FAILURE TO RECORD A 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 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ' 40 I`*',10~M GENT gil!,& am "M �;go OWNER or' ip W- •-01 MEMO Si? A:LA.Ar&A -1VAdAwl0e: 146 g2 Signed,-/# Date: 3 c) Before me this 4 county of Before me day of 2010 in the county of _SAay of 20104 cfn this Duval,State of Florida,has personally appeared Duval,S ate of Florida,has personally appeared hkaJ&e7774-/& h�q�� nc"y I J -Zr Al r, herin by himself/herself and affirms that all statements and declarations are herin by himself I herself and affirms that all statements and declarations are true and accurate. true and accurate. tary Public at Large,State of County of Notary Public at Large,State of f County of aill Known 0 21 Personally Known OProduced Identification- a Notary Signature: 17 unn 0 wa.,V... 0e-.. V PERDUE =C) i a Z OD769M 220. 1 ODD 947 10 it, 00,7 -4C 7,2012 k-4 it j1Wfic)nZZ1CJt. ERD JENNIFER S PERD e, My COMMisSION#DD7 STATE EXPIRES IVlarch 17,2012 'W'daN.,.,ySe"'Moom (�+]7)398 p153