2279 Seminole Rd Unit 11 Roof Permit CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
. > ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000275 Date 3/12/10
Property Address . . . . . . 2279 SEMINOLE RD UNIT 011
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3187
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Application desc
REROOF
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Owner Contractor
------------------------ ------------------------
VARAIN, JAMES A INTEGRITY ROOFING SYSTEMS
5570 FLORIDA MINING BLVD
ATLANTIC BEACH FL 32233 BLDG 300 STE 310
JACKSONVILLE FL 32257
(904) 260-1372
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3187
Expiration Date . . 9/08/10
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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.
i
CITY OF ATLANTIC BEACH
�} 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08-
sa OFFICE:(904)247-5828 Is FAX NO.:(904)247-5845
BUILDING-DEPTQCOAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
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gp-f, S D ❑NEW BUILDING ❑DEMOLITION PRESIDENTIAL
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OT -BLOCK_SUBDIVISION OF 4Wi$,p,�3 £G ❑ADDITION [3 CONVERTING USE 13 COMMERCIAL
®ALTERATION
13 ACCESSORY BLDG.
�E fA D \ E OLb n o>� L�C� 13 REPAIR ❑POOL/SPA 13 YES (AWA
- VV, �u ❑MOVE 13 OTHER
❑NO
9.NAME: 15.COMPANY NAME-
( �1-�q (-r y 23.COMPANY NAME:
�i�lYlE5 ;�, �t4P�1 ftu AID Fl 1109 sus e ms IN P-
16.NAME: 24.LICENSEE NAME:
ToseD 14 5 �£-s
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
,9a-79 SE,vI►P�►�IE (��, 11 SCC I'S;?--7S9S
PMAIN v,3-n C rS 67A G t+j F--L 18.ADDRESS: SCS-7 O Fr o i (54- 28.ADDRESS:
M101Ng �LVj), 310
�Z233 `3'ACKSelUdi LL*ET, FL 377S
11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: ----T. X NO.:
LPD t37.-,L- 1a(pp-1355
13 O 73 E 21.CELL PHO 29.CELL PHONE:
q04 .AL(4 - oSac Gcc{ i'1 3
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: OLCR✓Yl i N 30.EMAIL ADDRESS:
Ivt*e-ci r, ir0t n S s*elwr-4e-
31.NAME'' s .k 33.NAME.
35.NAME:
32.ADDRESS: 34.ADDRESS: 36,ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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: >tir
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.
In
Iu
All
Signed: 6. Date: Signed?this Date: A3
r�p^�
Befor this day of_ IMS{ 2010in the my of Before day of 20�rin the county of
Duv tate of Florida,has personally appeared Duval, of Florida,has personally appeared
SPron �s V A XI A-N 7-0&&-19 14- SA'mPJEs
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary Public at Large,State of
County of �l.�y i�-l.. Notary Public at Large,State of County of
❑Personally Known I`1 Personally Known
Iroduced Identification- F ❑Produced Identification-
Notary Signature: ` Notary Signature:
COAG FORM BLDG01:REVISED:1/10/2008
Doc # 2010044441, OR BK 15166 Page 502, Number Pages: 1, Recorded 02/25/2010
at 04 :10 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 I '
4
NOTICE OF COMMENCEMENT
(PRLOARE IN f7„P_ICA" )
Permit No Tax Folio No
State of r'ior_as Ccunt 7 y of
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.
Local description of property being improved. — Z ( z "7.-a'rd aC�
I SI :933RE ZQ. 9 ) �� � Su
Address of property being improved
t fA C P-- E+_
General description of improvements Rc rcof i na
Owner
Address old -7c3 SEM _- p 11_ �? �F 1T1 (3CAC t4
Owner's irterest in site of the improvement _ Rcsiden ce TZ7 L 3 ZZ 33
Fee Simple Titleholder(1 other than owner)
Name
Address
Contractor -nz:ecT-itv -Hcof_aq SvsLerts, -
Address 5570 _-Or_ca v: inc Alva 31 ct
scr.v_ e, F_. 32257
Phone No. 04/2E0-1372 ----�axNo _ 901/%60-1?SS
Surety(if any)
Address —Amount of bond 5 _
Phone No Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
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 be served.
Name
Address
Phone No Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienor s Notice as provided in
Section 713.06(2)(b).Florida Statutes (Fill in at Owner's option)-
Name
Address -- -
Phone No _.---- — _--Fax No.
Expiration Cate of Notice of Commencement(the expiration date is one(1)year f-om the date of recording unless a
different date is specified)'
THIS SPACE FOR RECORDER'S USE ONLY ER /
J�dl_ 3A_L 3day —.-..State of Flerc ras ersonally aopcareC in th
7�ms fi hersel`ane x irms that all statements and tleciaraTians ne ein m.by
a•e true am accurate
NotaI C Lala ;^� f L'vV_.-�
My commission eMpves --" -
°ersona!ly Known - - --
aroduced:dertlfirahai