Permit 1770 Mayport Road CITY OF ATLANTIC BEACH
T> 800 SEMINOLE ROAD
51)
ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5826
wy`rF31
Application Number . . . . . 09-00002031 Date 12/21/09
Property Address . . . . . . 1770 MAYPORT RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 53045
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Application desc
REROOF FL 1046
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Owner Contractor
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ASHOURIAN, POURAN BENTON BUILDERS & ROOFING INC
2865 PLUMMERS COVE ROAD ST 4
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32223
(904) 262-7663
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 270 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 53045
Expiration Date . . 6/19/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 270 . 00 270 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 270 . 00 270 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office:(904)247-5826 • Fax: (904)247-5845
Job Address: 11-10 M(X\j AO r -� k Q pL
Permit Number:
Legal Description {1-• .2S_ 20( E Pt Govt Lp 4 3 QC c Dfg r 10 g —1319
Valuation of Work(Replacement Cost) $_
• Class of Work(Circle one): New Addition Alter R a Move
■ Use of existing/proposed structure(s) Circle one): ommerci Residential
■ If an existing structure, is a fire sprier system mstalle , irc a one): Yes No ZA
�NDo• Is approval of homeowner's association or other private entity required? (Circle one):
Desscribej in detail the type
�oft�work to be performed:
.Y1) /1�0��`+c,C'sL1G l4lt" ti:+ 'tan� fb .e, 149
Property Owner Information
Name: Po k ro n A 5 h 0 k r i'0 h Address: , D 3 r C A VV e r)U e S ttA4 0
City J(icK%OnVi tie $¢" State fLZip 3225 0 Phone 90 q qQ3— rt392—
Contractor Information:
Name of Company: BENTON ROOFING Qualifying Agent: FRANK ROGER BENTON
Address: 2865 PLUMMR COVE ROAD, SUITE 4 City JACKSONVILLE State FL Zip 32223
Office Phone 904-262-7663 Job Site/Contact Number
State Certification/Registration# CCC035631 Office Fax# 904-262-7003
Architect Name &Phone#
Engineer's Name &Phone#
Application is her 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 aem it and that all work will be performed to meet the standards ofall laws regulating construction in thisjurisdiction. This permit becomes null and
void if work is not commenced within six(6)months, or ifconstruction or work is suspended or abandoned fora period ofsix(6)months at any time after work is
commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, wells,Pols,Furnaces,Boilers,Heaters,Tanks and Air
Conditioners,eta
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 COM M[ENCEMENT.
]here certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this pe
ofworkwill e complied with whether specified herein or not. The granting of a ermit does notpresunle to give authority to violate or cancel theprovisions ojany
other federal,state, or local law regulating construction or the performance ofconstruction.
Signature of Property Owner: Signature of Contractor:
Sworn to and subscribed before me Sworn to and subs(Wibe /efore me
this 1'iIDay of D Q c 2_009 this 15+k)ay of D e_ C Z B D 4
Notary Public: Notary Publicz, C
JAMES H.MILLER ion DD R
Commission DD 788236
Expires June 1,2012 ' k �June
i,2082236
„ Bonded flThN Troy Fein InSwenw 800.385-7019 �:ws r �eee
wt'.agt tegy A00 9p17019
DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY
Zeview Result(Circle one):
Approved Disapproved Approved w/ Conditions Review Initials/Date:
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 2.C) 3 - O t DO
State of Florida County of Duval
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: 1 Z S - '� �T �y� LOr 3
Address of property being improved: on 1 (z� ��av�t C g�" 'n "
General description of improvements: k'Q r o c fo j ie ft r) I
Owner PocLmviS n r "Q
Address SO 3r ve " S 1 40► 3 c. tsonJii e ISL 32Z�0
Owner's interest in site of the improvementF4E!e S I mp be
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor Benton Roofing
Address 2865 Plummers Cove Road.; Jacicsonville, FL 32223
Phone No.904/262-7663 Fax No. 904/262-7003
Surety(if any) /U
Address Amount of bond $
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 date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a
different date is specified):
/i /�
THIS SPACE FOR RECORDER'S USE ONLY ,, Ca,OWNER„