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Permit 253 Seminole Road CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000528 Property Address . . . Date 4/29/10 253 SEMINOLE RD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5840 ------------------------------------------------------ Application desc reroof/roof over ------------------------------- Owner Contractor ------------------------ ------------------------ WEISS, ROBERT G. EXCEL 253 SEMINOLE RD. 2368 SANDY RUN DR NORTH ATLANTIC BEACH FL 32233 MIDDLEBURG FL 32068 (904) 463-3438 ------------------------------------ - -------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee Issue Date . 00 Expiration Date . . 10/26/10 Valuation 5840 -------------------- ---------------------- --------- Fee summary Charged Paid CreditedDue ---------- _______ Permit Fee Total 80 . 00 . 00 Plan Check Total 80 . 00 . 00 . 00. 00 . 00 . 00 Grand Total 80 . 00 80 . 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 $EACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904) 247-5845 JobAddress: 3,5-3 ,nti i y cLC �p 4 lq/l�u FL 3 Permit rmit Number• Legal Description Valuation of Work$ �qde�, oor Area o t Parcel# Proposed Work heated/cooledt non-heated/cooled Class of Work(circle one): New Addition terati 4S •� �O"�Y�a��-� Repair Move Demolition pooUspa window/door Use of existing/proposed structure(s) (circle one ercial If an existing structure,is a fire sprinkler system installed?(Circe one): eszlkil , N/A Florida Product Approval# L qr For multiple products use product approval+ orm Describe in detail the type of work to be performed: a ` .SY 2ilc, 'tcc.e luc-44 foc..(' Property Owner Information• [Name: J,-4 V, t Tv� Address: J.S 3 City a,, P. , � State FL Zip 36L3 3 PhoneFL 3��33 E-Mail or Fax#(Optional) — '-- Contractor Information: Company Name: r--X-EZ Address: del Qualifying Agent: o7T-_S-OZr--n SL 04 �Oa., rl. Office Phone ( fit ��,� City. A',VnL&i3v < State )CG- Zip 3 X GLa� State Certification/Registration# ttdC Job Site/�Contact Number y 5,6— Fax# 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 perto do the work and in as indicated. I certify that no work or installation has commenced prior to the ssuance of a permit and that all work will be performed to meet the standallthisjurisdiction. This permit becomes nullnd void if workis not commenced within s (6)months, or if construction work is suspended or abandoned for at I sju d d i stx 6)months at b time �vork is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnacet Boilers,Heaters, Tanks and Air Conditioners,eta y after 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 YO14i NOTICE OF COMMENCEMENT. here b certify thatl have read a exams ed this plication and know the same to be true and correct. fill provisions of laws and ordinances governing this pe ofYwork will be com 'ed w whet r cid herein or not. The granting of a permit does not presume to give uthority o violate or can ^ovisions ofany other f e Z, e, or to regulating construction or the performance ofconstruction. /a cel the ignature of Owner int Signature of Contractor NameFvq J EE ( R�T�Tc Print Name ................... .......................................... .. .. ,)�on1 to and subscribed before me is-XjDayof At?Ri� 20A S`Fs and _ M �© t'�''•• U ^ w J-1 cvt IYVI n I.._ MIS& �! 0957760 A�aI y Public � w�VO�"; 5°�Sr1Ji�r1IN1/V1MAnn� X� r. 14,2014 SUSAN SPEAKS GORMAN T � MY COMMISSION#DD643668 P EXPIR8S:February 25,2011 Revised 01.26.10 1-800-3-NOTARY FI:Notary Discount Assoc.CO. 0tr-1U-db01 07:58 FROM:CLERK OF COURTS 904 270 1512 T0:92475845 P:1/1 NOTICE U� O uoc nzoTOor/eti.bi dK 15' Number Pages:t uo P'ec'Onie6 04!29/2010 at 03:39 PM, Permit Na 00•- d t� QQZ� C FUL ER CLERK CIRCUIT COURT DUVAL T1ucFolio No. __ PECoP,O1NGSt0_00 M UNDERSIGNED hereby gives notice that improvem®ts will be made to ce►tain real Property,�d m accordwca 77.3.13 of,the Florida Statutes,the followiag iaformation is provided in this NOTICE OF COIVTNI')&NCIEMXNT. `nom SocUon 1.Da4cripoon of property((era(d rcrodon):_ a)Strootescrfp(Job)Address: 2.t3oneraldescriptionofimprovements• Qeof et tecaoa Or�� 3.Owncr Information a)Name and address: VeFF IV, r r 1 i of AS-3 Se.,..h a[. 2a�► �(��tC,<< �,.� Ick 31�7t33 b)Namc and address of fee simple titleholder(i f other than owner c)1�1terest in ) Ss!,��:..a Ro.. IRl�\w.•i �-cc4 FL 4.Co"tracto Property-_Ot.c/nE 2 r Information a)Nxmtand addrea.a: 07 SOR �t,E.'S—ci�f�'� SAwaY 1� c _ b)Telephone No.: F[ 3 dato Y 6511M Infonna8on Fax No.(Opt.) a)Namc and address:_r( N b)Amount of Bond.- c)Tclepbono No.: 6.,Lcndcr Fax No.(Opt.) a)Name and address !) f¢ 7.Identity of parson wimi n the Stn a of Florida dcsi +�.� Phone No. a)Name and address: �d by o`er�whom notices or other documents may be served: b)Toleph000 No.: 'Y Fax o_(Opt.) 713.13(1)(b),Florida Statutes. ss N 8.10 addition to himse-I-;owner designates the following person to receive a c:apy of the Lienor's Notice provided in Section S a)Name and address: b)•i'elepbone No.: k ax No.(V pt.)dato ofNoticc of Colnmencememt the ( pt') is. ecifi ( expiration date is one year from the date of recording stales a different date WARNING TO OWNER: ANY TAXMNTS MADE By TE[E OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED EWpROPER PAYMENTS UNDER CHAPTER 713,PART 1,SEC'T'ION 713.13, FL0'UDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IWIR.O'VIEMEN'fS TO YOUR PROPERTY. N07'ICT OF COMMFNCFbWMT'MUST RE"COP-Mg-4,M POSTED ON THE JOB SITE BEFORE TH1E.FIRST TN5IPECTTON. Q+YOU INTEND TO OBTAIN FINANCINS XOUTt E D1SR OIL AN ATTORNEY BETORE COMMENCING WOKKOR RECORD.INC;XOUR NOTtC OF NCE "ATs OF i LOWA, 10. Sighat=of 'sAut6 01$Cei/Director/PsnvetMu gw De Print Numc The.forcgoinp instrument was aclmowledged before me this 0-4 day of_A1(3 t l 20,9-,b5r �EFFF F�� as (type of authority,e.g.ofScer,trustee, attorney in Tact)for 3Ef;FQt`� \i 1 TTt To (nme of party o1a behslf of wb,oynitastrtl.ment was csecgtcd). Personally Known_OI.L pro duced Identification - NotarySignature rn,� Type of Identification Produced V 330S$Stab Name(print) kS AOQ ORhKS C�,Zmsn1 Vmlf cation pur.uant to Section 92.52.5,Florida Statute,;.Under pe 'es U• cyjury, -c that I have read the forcgoing and that the 1'nt l v aatrd il:, .t.ti e true to thrr of my kncwledgc and belie wv+nn.t.v�+�nn SUSAN SPEAKS GORMAN [ MY COMMISSION 11100".1669 Signature o :ton Signing(in 1410 N 10. A R 'F 25•'m)I h 490G3lAiARY FL Nan UMW Argo.Ca,