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Permit 395 6th StreetCITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000780 Date 6/17/10 Property Address 395 6TH ST Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation 6700 ---------------------------------------------------------------------------- Application desc reroof fl 5444 ---------------------------------------------------------------------------- Owner Contractor ----------------- PEEK ------- --------------------- BLALOCK ROOFING, INC. --- 395 6TH STREET 10737 NEW KINGS ROAD ATLANTIC BEACH FL 32233 SUITE 106 JACKSONVILLE FL 32219 (904) 766-6190 ---------------------- Permit ---------------- ROOF PERMIT -------------------------- ------------ Additional desc . Permit Fee 85.00 Plan Check Fee .00 Issue Date Valuation 6700 Expiration Date 12/14/10 ----------------------- Special Notes and --------------- Comments -------------------------- ------------ NEED NOC ----------------------- Fee summary ----------------- --------------- Charged - - - -------------------------- Paid Credited ------------ Due Permit Fee Total - - ----- -- 85.00 -------- ---------- ---- 85.00 .00 ------ .00 Plan Check Total .00 .00 .00 .00 Grand Total 85.00 85.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ~__ __. ,,~'~"`- 1 - , r~"~' ..,., Date: (!! "~ / /' CITY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION Job Address: _~(~.~ (l~ `-~ ~~~ ~-t'I / C~/1~~ ~ l_~-Q~C~`" 09 - t7wner of Property: ~_~~~ .~ ~°\~' t~rtule~.i~ ~~ =k~~ Address: 1~~~ J~`(~.~ Telephone: ~ ~ lSJ ~(p Roof Contractor: ~(,(,,(aC.,}~ ~,p(~ir. __CI~._ ~G- State License Number: ~~ / 3~31~. Contractor's Address: Telephone: /(.~(p ' lQ ~/U fax: ~(~~ '' (~ ~~ Email:~~!}~ix~.(~ih.~~C~'r"~/(~ Scope of Work: K ~~'p~~ Roofing Material ~ FL Product Approval # ~~.-- J ~'1'i Valuation of Work: ~n p, l~y Required Inspections: Sheathing /In Progress-Dry In /Final If re-roof: Assessed Value of Structure: _ < $300,0(~(iJ~3t>t0,"<100; Roof-to-wall improvements required? ~j(~ ( Applies to single family structures only) "WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. If YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR !ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT" Signature of Owner: ~~~ ~ Date: ~ ~~~ ~~~ ~:. AS TO OWNER: Sworn to and subscribed before me this day of ~v /L.~2 , 201 . State of Florida, County of Duval „ WILLIAM !POPE ~ Notary's Signature: li,,: ~~~,,=~.,,~~ 'f~~,-, Notary Public, S1ak of Florid ~ Personally known My Comm. exp. OCl 19, 201 t ~ Produced identification Comm, No. DO 714216 Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me thi s ~~ day of .~e./!l,(' , 20~C) . State of Florida, County of Duval '- / ~ N ' Si ~ ~ ' WILLIAM l POPt otary gnature: 1~ s ~~ / C1Y ,2 Notary PubfiC, Stale Ol FIUi; ,'Personally known My Comm. eX~. OCI 19. 2s'` ^ Produced identification Comm ~, pO T147~~ Type of identification produced C~ 00 Seminole Road Atlantic Beach, Florida 32233-5445 . one: (904) 247-5800 Fax: (904) 247-5845 OCT-29-2001 07:57 FROM: CLERK OF COURTS 904 270 1512 70:92475845 Pemlit Number Tax Folio Nttmber NOTICE OF COMMENCEMENT STATF, OF FLOW.DA, CUUNTY O1F DUVAL 'I'HF UNIJERSIGNED hereby gives notice tblat improvement will be made to certain real property, and 111 accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. P:1~1 I . Description of property (Address): ~ %,~ l~~ ,)'t'r ~p~` ~ i~ie~C~ 2. General description of improvement: fi pft;~. 3. Owner information: _ 1. Name and Address: .JC~'Q ~nr{ ~Q_t~~p j~ 2. lntcrest in property: ©l.,~ar~p~("' 3. Name and address of fee simple titleholder (other than owner): C („~A ~"ts 1G 6GiC 7 euv ~•55 ct. Sie. t~t( 1 L `_ !4. Contactor's name and address: (3,~~~ ~~ a. Phone number: p J b. Fax number: c~C`/ 7 la (o ~a l g / 5. Surety lnformaliun: a. Name and address: b. Phone Number _ c. Fax Nutitber: - - --d:~ --z4rrtourrt oft3ond- G. :Lender's name and address: a. Name and address: b. Phone Nunlber: 7. Person within tine State of Florida designated by owner upon whom notices or other documents maybe served as provided by 713.12(1)(x), Florida Statutes. a. Name and address: b. Phone number: _ c. Fax number: ~. In addition to himself/herself, owner desigt:lates of to receive a copy of the Lienor's Notice as provided in Section ? 1 ?. ] ?(;)(b), Flo: rda Statutes. 9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of ltccording unless a//d~~if~erent date is specified) ~(Signaturc oJ'Owner: /''~!f¢~ --~ Sworn to and subscribed before me this ~ 7 day of ~ v~t.~ _ , 20 /V . Notary: ~l~u~ ~/ WllllAM l POPE ffc:l8wn~esFe/1D shown: Notary Publ_k, State of Flpdda y conpn, exp. Oct 19, 2011 My commission expires: t:omnt, No. OD 11~A'Ig 0oC7F201v140i53,~.~tBK'lo'1%9regCya'i, Number Pages: t P.ecorded OW'17rZ01Ual 03:33 ..°M. ,iIM FUIIER CLERK CIRCUIT COURT OUVAL COUNTY RECORDING 510.00