Permit 1747 Park Terrace WestCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 10-00000802 Date 6/21/10
Property Address 1747 W PARK TER
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation 7450
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Application desc
REROOF
Owner
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JENNINGS, LINDA A.
1747 PARK TERRACE WEST
ATLANTIC BEACH FL 32233
Contractor
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FISETTE CONSTRUCTION & REMODEL
2336 PINE ISLAND COURT
JACKSONVILLE FL 32224
(904) 992-4782
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Permit ROOF PERMIT
Additional desc .
Permit Fee 90.00 Plan Check Fee .00
Issue Date Valuation 7450
Expiration Date 12/18/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 90.00 90.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
Permit No.
Tax Folio No.
a) Name and address:
b) Telephone No.: ~
Information
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal
a) Street (job} Address:
2.Generai description of improve
3.Owner Information
a) Name and address: 1,~~_,''~,~d~~~~~{~(L""1~y~G1CG j~/p.$~f-~A~'bvN~ ~'~gc,~ ~f ~'3'LZ~
b) Name and address of fee supple tittehol (>f other than owner)
c) Interest in properly /'hq/ytrit/
4.Contractor Information ,. . , .. ~
~`~~
uoc ;i 2v7 G t 4[;3r3ti, UM 8K t S2~ i rage i t 33,
Number Pages: 1
Recorded 06r212010 at 10:40 AM,
JIM FULLER CLERK CIRCUIT COURT DUU'AL
COUNTY
RECORDING $10.00
Fax No. (Opt.)
Fax No. (Opt.)
a) Name and address:
b) Amount of Bond: _
c) Telephone No.: _
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address;
b) Telephone No.: Fax No. (Opt.)
8.In addition to himseli; owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(6), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date of recording nniess a different date
is specified):
WARNING TO O'9VNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IIViPROPER PAS UNDER CHAPTER 713, PART li, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IlVII'ROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCF,MENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COL1NrY OF PINELLAS 1 O.
Si f Owneti o Owner's A pfficedDi~ctnr /Manager
t I? ~l/
Prim Nerve
+,i..
The foregoing instrument was acknowledged before me this ~, r day of ` :1 „~; ~ ~ ;G=_. , 20 1 ~- , by ~~ , f,: ~ .~-
_...,~-
(- J ~"-~ ;'~~ ; ~.`=1-:~-`~ as (type of authority, e.g. officer, trustee,
attorney in fact) for (name of party on behalf ¢f-wbom instrument was executed).
>_ _.
Personal] Known OR Produced Identification ~ -°°N --~----..
y _~/ Notary Signature .~-'-~`~...~'~ •~~ = t, ~= ~j\
• ~ _....o----~ ~ l1~
_ __
T e of Identification Produced ~ -r
YP "~'~-' Name (print) _~ ~} .-t...i~ ~.~ ~-~,ie..ti.~-x~,~~"t*
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
FoxMSmroc,~azoro
Signanue ofNatural Person Sigtring (in litre # 1QJ Above
BUII.,DING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address:
Legal Description 3~ ' $s bq - Zs n
i~
Number:
ri~ur 1-~rca ul oK.l~ ~. v~i•i
Valuation of Work $ ~~• ~ Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pooUspa window/door
Use of existing/proposed structure(s) ((circle one):. Commercial esidential
If an existing structure, is a fire sprinkler syst m installed? (Circle one): es o N /A
Florida Product Approval # L 2,
For multiple products use pro uct approv orm ~ ~
Describe in detail the type of work to be performed:
Property Owner Information:
Name: ~ ~ Address:
City State Zip 39~P
E-Mail or Fax # (Optional)
Contractor Information;
Company Name: ~ Quali Agen : 1 I `
Address: l v City State' Zip X250
Off ce Phone - - q Job Site/ Contact Number J~ /- p(p0 ~O Fax # ~~p - ~~~
State Certification/Registration # C.GG t~2q'1.g7
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 o, f 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 f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a__pertod of svc1(i) months at any time after
work is commenced. I understand that separate permits must be secured for Electric Work, Plumbing, Signs, wells, Pools, 1 urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMIIIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO~LTR NOTICE OF
COMMENCEMENT.
I hereby certzfy that I have read and examined this~plication and know the same to be true and correct. All provisions
type o work will be complied with whether sppeci ed herein or not. The granting of a permit does not presume to
provisions of any other federal, state, or local Imv regulating construction or the performance of construction.
Signature of Owner Signature of C cto
Print Name 1 ~ n ~ Print Name ~.
...:
.Q..c~ ..........................................~.~...........t..~I......... ~~---..................._.........
laws and ordinances governing this
> authority to violate or cancel the
Sworn to and subscribed before me Sworn to and subscr bed before me
this Z/:s ay of 'TuN ` , 20 1G~ this ~/ Day of ~.~Hn/~ 20 /0
of Public Not ry Public
Revised 01.26.10