Permit Folder 780 Amberjack Lane �;t t 'V
CITY OF ATLANTIC� IC BEACH
„. 800 SEMINOLE ROAD
N . ATLANTIC BEACH FL 32233
4 ;f1 INSPECTION PHONE LINE 247-5826
APPlication Number
Property Address 10-00000318
Application type description 780 AMBERJACK LN Date 4/01/10
P y Zoning SIDING PERMIT
Applicationvaluation TO BE UPDATED
- 3200
Application desc -----'-----
------
Replace_ siding with hardi --------------------------------
_ _ plank-siding, overhang
Owner-- ------------------------------------
NOTTMEI-- ERIC------- - Contractor
1875 BEACH AVE & TRACY SYNAN ------------------------
CYPRESS BAY BUILDERS
ATLANTIC BEACH
FL 32233 PO BOX 1652
---------- --- GLEN ST. MARY
Permit
------ ---_
----------- (904) 703-5262 FL 32040
_____
Additional desc BUILDING PERMIT -----------
Permit Fee --
Issue Date 70 . 00
_Expiration Date 9 ValuationPlan Fee 35 . 00
--
-------- /28/10 3200
Fee summary -------------------------
----------------- Charged Paid --------------------
Permit Fee Total --- -----__--- Credited Due
Plan Check Total 70 ' 00 70 . 00 ----------
Grand Total 35 . 00 35 . 00 . 00 . 00
105 . 00 105 . 00 . 00 . 00
. 00 . 00
BUILDING PERMIT APPLICATION
f CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: _'Z6 O A M btn ckc k LQ y�x Permit Number: /Q 1 O
Legal Description Parcel#
Valuation of Work$ J o� (D (gJc,oc� a
Class of Work(circle one): New Addition Iteration/ Re a' Move Demolition po a
Use of existing/pro osed structures)(circle one): ommercia i entaa
If an existing struc�ure,is a fire sprinkler system installed? (Circle one): es o N/A
Florida Product Approval# �r L t 3 Q3(C By Q
For multiple products use product approval form
Describe in detail the type of work to be performed: 0Lt o1(A(0 V i n)lI and wo& Sjd j'/)(, O-) (�nn1 �SJC�j
hl)rv� �,� i �1GfCII IQn 1' 1�I' 1 I r W1 OAA-
0
vG'
Property Owner Information:
Name: r ca k S r%h Address: 1X515 13 (a Cit A vC
City G fi° G Vl State Zip 322-3-?. Phone (9 6�)
E-Mail or Fax#(Optional) 5,i,. C,nt-c) (p M C C,,` , ,•���
Contractor Information:
Company Name: IJV p c,S (30tQualg Ag
ent:
Address: D O f3 Uyt(e 5'z.
Office Phone in
9aK qs3 T-- 2c Job Site/Contact Numbers Fax#ate Zip
State Certification/Registration#_�,.[1 1 S'1 i 1. y
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Applicati�ishe reby made toobtaina permit to dothe work and installationsasindicated. I certify that no work or installation has commencedprior to theissance a permit and that all work wall be peformed tomeet thestandards of alllawthisjurisdiction. This permit becomes nulland void ork isnotcommenced wthin six6)months, or if constructionorwork is suspended or abandoned for apertod of six 6)months at arty time afrerwork ismenced. I understand that separate permits must be secured for Electrical WorIS Plumbing,Signs, Wells,Pools, urnaces,Boilers,Healers,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here b cert that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to gave uthoriry to violate or cancel the
provisions of arty other federal,state, or local I regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name
....... .................g�.q C:.. .................... ..t l_Q. ........................................... Print Name I�.....�'. ..............�L.s.
a b db � ?'3�� o "`�r., . -trti1..........................
Sworn to and subscri e e ore me 7 /'{ 3 0
this 23 Day of /I'(it rc 11 20 / Sworn to and subscribed before me
this Da of 20/0
Notary Publi Notary Public
vfrr Notary Public State of Florida
Nancy E Bailey
My commission OD745822 �Vgr ry,, Nod ry Public State of FIA'1S O l.26.10
; Expires 0210812012 `rg, Nancy E Bailey '111`1'r
My Commission DD745822
orw Expires 0210812012 01-11
AUG-4-2001 02:35 FROM:CLERK OF COURTS 904 270 1512 T0=92475845 P:1/1
NOTICL OF COIAMNCFMENT k
IPREPMlE IN OUPLIGATiI
Tax FoNo No.
permit No. County of
Stele of
To whom K map concern:
The undersigned hereby 1~5 you that irtlPlvve�m will be made to stated in this i ancEI�
eccordarrce with Section 713 d the Florida Statutes.the following NttontraRbn
COMMENC@MENT• --7
X0 A M I7
Legal description of pro0er►Y being krrproved:
Address of prop"bang improved:
4
v
General desaript W of Improvemero:
owner ���` Ce
t
Addrea9 —
gvurrer's interest in site of the irrrPr' d
Fee Slmpte Titleholder(if ot"w than owner)
Name
Addresscontradtor
L
tJ
Address
Phone No. q d� Fax No.
Surety of any) Am%Mt of bond f
Address
Phone No.
Fax No.
Name and addresa of any person making a roan for rho oonatmctlen of the impnd°errw ts.
Name
Address r
Phone No. Fax No.
Marne of wMtn the State of Florida,other than himself,daslgrrate0 by owwr upon vAwm notices or
N per, D l5
documents may be served: n e 3 2410
Name 1V1 A
Address
PnOne No. Fax No.
In addition to himself.owner designates the following person
tor""a copy of the uenoPs Notice ea D y
Section 713.08(2)(b).Florida Statutes.(FM In at QwnWs uAml)-
Name
Address
phone No. Fax No.
F.x 0tion date of Notice of Commonoemant(the expiration date is 1111!(1)Year horn the date of recording fleas a
dtlfetent date is specMsd):
THIS p�E'Rp}Z it RDER' l7 NlY �=o TE
r":
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10UtAb4�1.(JR bK 1558td Page 1414.
vpe 'amu am"hv r d i1 �, ; a� DARRICK SMITH
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