Permit 136 Pine StreetCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 10-00000796 Date 6/18/10
Property Address 136 PINE ST
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation 3870
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Application desc
REPLACE SIDING (DAMAGED)
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Owner Contractor
TAFFLIN, MARC ROZAFA BUILDING ENTERPRISES
136 PINE STREET 9313 WESLEY COVE COURT
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257
(904) 674-2253
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Permit ------------------------------------
BUILDING PERMIT -----------------
Additional desc .
Permit Fee 70.00 Plan Check Fee .00
Issue Date Valuation 3870
Expiration Date 12/15/10
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Fee summary
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Charged
---------- -- ---------------------
Paid Credited
-------- ---------- -----------------
Due
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Permit Fee Total 70.00 70.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 70.00 70.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORH)A
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: __~~ ~0 ~+iJ ~ -`~1-~-~~ Permit Number:
Legal Description - `~`~S~ ~ C1 ~ S '~ ~ S ~ C ~ Parcel # ~ ~a ^ ~ ~
oor rea o q. t. q. ''t
Valuation of Work $ v Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) ((c>trcle one): Commercial Residential
If an existing structure, is a fire sprinlder system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: ~l ~ (,~ ~ A~~1 ~ ~,~~ ~ fl
~~XT~ (~ ~ ~ ~ I ~Cn 1 ~ S'r~~
Proaerty Owner ILnformation: > [
Nam L E~ Address: "I ~ ~22~'~
City ~ ~- State Zip ~ZZS~Phone ' ~ r-
E-Mail or Fax # (Optional)
Contractor Information:
Company N
Qualifyin~Agent: I~'\ d ~
Citv,C7~ G S~ln ~fi 9_._
Office Phone 1 Job Site/ Contact Number
State Certification/Re istration # ~~ ( 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. 1 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 if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_ peraod of six 6) months at any time after
work is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, furnaces, 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.
1 hereby certify that I have read and examined this~plication and know the same to be true and correct. All provisions of law and dinances governing this
type o work will be complied with whether speci aed herein or not. The granting of a permit does not presume to gav a thority violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner ~'~ Signature of Contracto
Print Name ~.'f~..l`y f'S'~\...._..~..~....~'~`~ 1~.~~.1~'`~...._ ............... Print Name ~_~iZ:S,:~~.. (,,.V'~...........)~,~.~:.................................
Swo t~.gnd subscribed before me Sworn t~~~ndysubscr~ ~d be~c me ~,,(
this =may o 20 thi ~_ of r~~ 20 ltd
11 ~ ~ ..~ ~ ~ _ n
Publtc~'' •~..~ ~ ~~ KATIE FRANCES ZES otary P b Ic TIE FRANCES ZES
_• `~': otary Pubtie -State of Florida ; o'~ „ ~~'' i fate of Florida
. • . My Commission Expires Oct 2, ZOt 1 ' ~' t ro ~~~.
• My Comm ss on xpfres Oct 2, 2011
'~,~}~'o~r~o°`~` Commission # DD 72108f "~ #o°: Commission # DO 721081
,, OF f~ O
,~~,m• Bonded Through NaUa~ Notary Aan. ~°r~,,,,,,~~~` Banded Through National Notary Assn.
Farx-# (p~-fir- ~3
e Y> C^r~ J-..a P: 1
OCT-30-2001 08:19 FROM: CLERK OF COURTS 904 270 1512
NOTlC~ ~ OMM1i;NCF
Permit No. ~ .~~~/`__~~
Tax folio No.
70:92475845 P:1~1
OoC Tf 20101 a1 btf4. UFt 8K 1:itcw t'age 3295.
Number Papes: 1
Recorded 06/18+2t)1t) at 04:01 I'M,
JIM FULLER CI,EP,K C(RCUl7 COUP.T DUVAL
COUWTV
RECORf7lNG 510.00
THF; (1NC)t=,itSIGNF•D hereby gives notice that impm~emcnts will b¢ made to cetttiin real propcaty, and in accordvtce with Section
71?, t3 of the Florida Statutes, the fol)owitlg irs!'urntation is provided in this NOTICE OF COMM~iC~MENT. _ ~ ~ ,
I .DeKCription of property (101
a) Street (%oh) Address:
2,Gcncral description of improve
3.Owner Information
a) Namc and addres.~~,
b) Name and address of
c) lnterect in property ~
4,Contractor Infomnation _
l ~ „/~ b~ a) None and lddfess;
b) Telephone No.: (t
S.Surcty [nfermatinn
a) Namc and address:
b) Amount ol'l3ond:
c) Tckphone Nn.: _
G.Lendcr
a) Name and address:
1C~cMP-ECZ ~F~f~ ~s~'hP~s'~~ S~`t~`~1~ti1-- ~ ?~225~
titleholde>• (if athcr than owner) _ _
Fax No. (Opt.) ~s %~"C
Fax No. (Opt.)
1?ltunc No. _ ••~
~~LE.
~~'- ~2.`~.s~
7.ldcntity oC person within the State of Florida deal aced b'Y' rnvner u n whom notices or other d umcrris may be served:
a) Name and addrec<r" `~./p-- ~~{~ Co~U; ~~~ ~~ ~'j1~~} ~,( `_
b) 7clc;phwtc lvo.: ~- -~--J Fax No. (Opt.)
S.In add'+tion to himse)1 owner designates the i'ttUuwinl; person to receive~a copy ofdle .t,ienor's NotiCC as provided in Section
713.11(1)(b), Florida Statutes:
a) Namc and address:
b) Telephone No.: -- • .... _ -.. Fax No. (Opt.) •- •• ..
9.Expiration date of Notice of Commencement (t:1+c expiration date is one year tram the date of recording unless a different date
is speCitiM)s
WARNJING TO OWNER: ANY PAYMENT5 MADE RY TIaE OWNER AFTER THE EXYIKATION OF'iHJE NOTTCE OF
COMMENCEMENT AFiE GONCJ~ERIED llil)i ROPER PAYMEN'1'5 UNDER C]i1.A.PTER 713, PART I, SECTIQN 713.13,
~'1.ORma STATUTES, A,ND CAN RESUi.T iN vOUR PAYING TwiCE FOR 1IMPROVF;M1cNTS TO XOUR PROPERTY,
A IVOTiCE OF COMMENCF:MFNT' MtJ5T' BI; RECORDED AND PO$7'F,t7 ON TJiIE JOB SITE BEFORE TFIE F'1JitST
INSPECTION. IF' XOU INTEND TO OBTAIN F'eN.ANC.ING, CONSULT YOiJR I.BNUF.K UR AN ATTORNEY BEl~OR>t;
COMMF: . ,~~„~,bi~ ~71E fRgNCESZE9 OT1CF, O.F COMMENCEMENT.
rTA7'IL oR Nr. • Notary PuOfie - StNa of f ItltiAa
f:ptlrw~w oP ~ ' " Mn Comndssion E>~Ires Oq 2.2011 10. ~ -^ Q
Conlmisetoa M t10 721061 Si of flamer rar 0 r'3 Au1 d C)ftSccr/Dirxmr/Partner/Nt~i,.er
~~•..N BOndedlMolpNNstionelNoaryiissn.
The foregoing instrumcrtt was acknowledged before me this ~ day dl~,,,_ ...~ 20tV , trK~SG ~h
• ~ ~l ~~ .. (type at authority, ag. ofllaCer, trustee,
attoracy In fact-~'pur, .~ (name of party ~ belu-U of whom inctrvmcn t vyRS~ute~.
Personally Kno~(_ O!t Produced Identification ~ Nolary Signature _,_ ~`~,~
~ ` ~, r .. .
Type of Iderttification, Produced - _ Naxrlc (print) ..•. ~"~i ~ t
OR
Verification pursuant to Section 92.525, Florida Ststut~c. Under penalties of perjury, t declare that 1 have read the foregoing and that
the fltcts stated in it arc iruc to the best of my knowiocigc and belief.
I'ONMWNIN',h,A2nIA
Signature orNaturd Pelson Sig+~ing (in line H ln.) Atwve