Permit Roof 2010CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 10-00000969 Date 8/03/10
Property Address 1961 MIPAULA CT
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation 6500
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Application desc
reroof f19631.7
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Owner Contractor
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GANN -----
D.S. KILLIAN ROOFING AND
GENERAL CONTRACTING
ATLANTIC BEACH FL 32233 3898 DUPONT CIR
JACKSONVILLE FL 32205
(904) 388-6604
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Permit ---------------------------------
ROOF PERMIT
Additional desc .
Permit Fee 85.00 Plan Check Fee .00
Issue Date Valuation 6500
Expiration Date 1/30/11
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Fee summary ------------------------------------
Charged Paid Credited
---------- ---------- ---------- ---- Due
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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.
NOTICE OF COMMENCEMENT
Permit No.
Tax Folio No.
UOC 7i LQ"It118t1596, iJt( tiK 153L~ E;age L1:[8,
Number Pages: 1
Recorded 08103!2010 at 03:56 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY -
RECORDING $10.00
TI-~ UNDERSIGNED hereby gives notice that improvements will be made to certain real properly, and in accordance with Section
713. I3 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of properly (legal alescriptxon):
a) Street (job) Address:
2.General description of improvements:
.3`l` ` ~ ~ d ~'~ b ~ '~~ '~ ~' Se l ~~ ~(/~:~ Ufa ~ c/~
l
3.Owner Information
~~
a) Name and address: ,,J. / /yl r ~'o /S~ y ~G1~~
b} Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4 Contractor Information
a) Name and address: ~~~1/
b) Telephone No.: ~ ~ o~ ~L
S.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
~~~~~v/S
6.I,erfder
Fax No. (Opt.)
~ ~ r. ~~ ~`i. 3da5 z
Fax No. (Opt.)
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.)
S.In addition to himself; owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of N°~ce of/~ommencement (the ezpira6on date is one year from the date of recording unless a different date
is specified): /'~ / ~l / / O
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OR'NER AFTER THE EXPII2ATION OF THE NOTICE OF
COMIVIENCEMENT ARE CONSIDERED IlVIPROPER PAYMENTS UNDER CHAPTER 7I3, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMME MENT.
STATE OF FIARIDA
COUNTY OR P46-~ ~~~-- ~ 10.
Signalise of Owner or Authorised Officer/DirectorlPaitner/Menager
Print Name
)v,'~
The foregoing instrument was aclmowledged before me this ~ day of _-A'~ S 20 j~~ by
as (type of authority, e.g. officer, trustee,
attorney in fact) for _ (name of party o half of w)}om instrument was ezecuted).
n ~ //
~;~~~
Personally Known ~ OR Produced Identification Notary Signature i` ~~H°' ~~vl~`~~:~ ~
Type of Identification Produced
Name (print) ~ ~~~/ _1~ ~LI',~.~?<-~~!S
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penatties of p , I declare that I have read the foregoing and that
the facts stated in it are true to the best of my lmowledge and belief
aoxn~srtaoc,~sazoio '*°t;`"''.~' PAIA.B.PMSONB l ... ~ ,
# * MY COMMISSION # DD 891156 !
EXPIRES: June 2, 20f3 Si of n Si # 1 .
~~~'ov~~oT 8aeded Tlw &idget Ndary Savites
BUII~DING PERlVIIT APPLICATION
-'--" CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address• `
Le al Descri tion 5~'" ~y
a s _~~~ ~lr~~ Nariz ~~~ ~
(~-c> ~
g p oor ea o q. t. _ Sq.r't
Valuation of Work $ s U 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
If an existing structure, is a fire s rinkler system uistalled? (Circle one): Yes N /A
Florida Product Approval # ~i-- -
For multiple products use product ap rova orm ~
Describe in detail the type of work to be
Property Owner Infor~mAation: /~
Name: ~? f s' vl.G~~~~ y "` vlGf
City YLl ~ ~v State
E-Mail or Fax # (Opti nal)
Contractor Information:
Company Name: ~1~~~
Address: ~l S 3/Z~iri';
Pe ..Number:
arcel # ~ 3
?/
l~
~~ ~ ~~ ~"r ~ Qualifyin gent: % ~~~ ~ ~C ' ~!` ~~
Office Phone ~~7~ ~ o/ 7 Job
State Certification/Registralaon # CG ~
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 ceriz: fy 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 permif becamas natll
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a~enod of six~6) months at any time ajler
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, ells, Pools, urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etG
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
CONIlVIENCEMENT 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
CONIlVIENCEMENT.
I hereb certify that I have read and examined this a placation and know the same to be true and correct. All provisions of'laws and ordinances governing this
type o, fYwork will be complied with whether sppecij ed herein or not. The granting of a permit does not presume to give authority o violate or cancel the
provisions of any other federal, state, or local lmv regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name ~ ~ h ~ Print Name r.. f _.._ ..._.
Sworn to ands bs ed fore me Sworn to and subsc •' ed efore me
this " p Day o 20 ~' is Day of 20 /~
~~~~ ~~Q l6~~~ O~~R •~~'~
Notary Pu lac * * MY COMMISSIpW ~ pp 891 156 Notary Publ~ * MY tX)MMIS310N t DD 891 t5c
EXPIRES: Junye,,~2~~,~2013 EXPIREBS:~JuO_e 2, yp 01.26.10
Nf~~OFfla\~F 90f1d~d 11gU BU~'^^°~/SIfVIfRS ~9~OF Fl~`O! BOtl~1}IRI 1do~ry
City T State ~-- Zip ,3
Number (~~-( SZ~7 ~ K ? ~ Fax # 3~~1 - ~',~ 33
~~~