Permit 1777 Park Terrace W Vis'" k r r CITY OF ATLANTIC BEACH
r 800 SEMIN
? ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
10-00000382 Date 4/02/10
Application Number - . 1777 W PARK TER
Property Address . . •
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation 13000
Application desc
reroof f1183 --------------
---------------------------
Contractor
Owner
--------------
OUELLETTE, R. C. AAA ROOFMASTERS INC
1777 PARK TERRACE WEST 2446 TYSON LAKE
JACKSONVILLE FL 32207
ATLANTIC BEACH FL 32233 (904) 639-8766
------
-----Permit .
. ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 115 . 00 13000
Issue Date Valuation
Expiration Date 9/29/10
Fee summary Charged
Paid Credited
_ ------- . 00
----------
- . 00
Permit Fee Total 115 . 00 115 .0000 00 . 00
Plan Check Total • 00 . 00
Grand Total 115 . 00 115 . 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: k 7-7 Permit Number:
Legal Description Parcel#
Valuation of Work$ L�00 CD
Class of Work(circle one): New Addition Alteration Repair �esid
olition pool/spa window/door
Use of existing/proposed structure(s)((circle one):. Commercial If an existing structure,is a fires rudder system installed? (Circle one): N/A
Florida Product Approval# �
For multiple products use product approva arm
Describe in detail the type of work to be performed: F c-� `� ��` ^w 1-ts
Property Owner Information: i /
Name: L� �Cn �-tt-c Address: I 7
City t State_Zip Phone r
E-Mail or Fax#(Optional)
Contractor Information: n ,�
Company Name: A-{EI� !`�'0��� ' `� Qualifying Agent:
Address: 3� 'rte tr J►, City S"/X- State Zip
Office Phone I A 0 D LW 761Job Site on`t Number bd-q 7(,-L3 Fax#
State Certification/Registration# C C c- 1 3
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and 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 of work is not commenced within siz(6)months, or if construction or work is susppended or abandoned for a-perrod of stx 6)months at any time after
work is commenced. I understand that separate permits must be secured for ElectricaCWork,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
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 hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordi es governing this
type a1 Ywork will be complied with whether s ecif ed herein or not. The granting of a permit does not presume to give hority olate or cancel the
provisions of arty other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner 7y) Signature of Contr t
Print Name Print Name ✓
......................................................................................................................................... ,. . . ........... ._< ..........................................................._...
Swo to and subsc ' before e Sworn too and subscri A Wo
thim Da of 20 �U this M?X0 of
COMMISSION#DD789%2
NTotary Public ROBIN K.TUCK Notary u lie I 3�
F!�µocary$erviG.cam
'== Notary pWic.slots of Plorido - Revised 41.26.10
• My Comm.Expire=Sep 14,2012
z Commission!0101822466
sanded Through lotions Notary Asan.
NOTICE OF COMMENCEMENT ix)Folio No.
Permit No. of Duval
State of Florida,County be made to certain real propertyin accordance with
UNDERSIGNED hereby give notice that the im ove wedin s Notice ofComme cement
THE information><s pro
Chapter 713,Florida Statutes,the following
(legal descriptio of prop rty an addre available): .
° � - -
---------------- ---
1. Description of property( xi _ '. ---
��(� `�t(Cgc� � �c#20100r4706,Ott BK't5L0"! Page26i,
Number Pages: 1
rovements• Recorded 04!02`2010 at 0CUI PM,
2. General Descripti n of JIM FULLER CLERK CIRCUIT COURT DUVAL
7 COUNTY
RECORDING$10.00
3. Owner Information:
a)Name and Address:
b)Interest in property= ' `'
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address: ___
b)Phone Number:
5. Surety Information:
a)Name and Address:
b)Phone Number:
c)Amount of Bond:$
6, Lender Information:
a)Name and Address: as
b)Phone Number:
' the State of Florida esigna
provided by dted by owner upon whom notices or other documents may e s
7. sonwithin
� 13.13 (1)(a)7,Florida Statutes:
pro
a)Name and Address: o receive
b)Phone Numbers of Designated Person: of
g. In addition to himseigherself,Owner designates Florida Statutes.
a copy
of the Lienor's Notice as provided in Section 713.13 (1)(b),
a)Name and Address: mon or ording entity designated by owner: unless a
b)Phone Number of Pe year from the date. ec
Expiration date of Notice of Commencement(The expiration date is one(1}y
different date is specified: EXPIRATION OF THE
PAYMENTS MADE BY THE OWNER AFTER T� R 713,PART
WARNING TO OWNER' ARE CONSIDERED IMPROPER PAYMENTS UNDER.CHAPTE
Oh�MEN RESULT IN YOUR PAYING TWICE FOR
NOTICE OFC AND CAN MUST BE RECORDED AND
I, SECTION 71_ FLORIDA STATUTES' TO OBTAIN FINANCING,
IMPROVEMENTS TO YOUR PROPERTY, A NOTOREE THE FIRSTICE EC'TION�IFEYO� R RECORDING
POSTED ON THE YOB SITE
LENDERAN ATTORNEY BEFORE COMMENCING WORK O
CONSULT WITH
YOURNOTICE OF COMMMCEMENT.
X elOfftce
er .,�,..,.S,NigtL3lfliiit�'i
ROSIN K.TUCK
Signature of owner or Owner's Authorized Officer/Director/Partner/Manag Nat�1►P�.Std at Flo�d�
M
nt was'acknowledged befor me this-:- day of tN�hryM�l.
The going rostrum „. lonOtb
_for
(Name of Party Instrument was Executed for)
(Name of
ertonl (Authority Type,ie. fcerlAttomey)