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Permit Roof 422 Sargo 2010 `£ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001204 Date 10/O1/10 Property Address . . . . . . 422 SARGO RD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4500 ---------------------------------------------------------- Application desc REPLACE ROOF PRODUCT APPROVAL CODE FL 459 ------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HAAS, ELIZABETH MANN'S ROOFING AND WATERPROOFI 422 SARGO RD NG LLC ATLANTIC BEACH FL 32233 2114 UNIVERSITY BLVD W JACKSONVILLE FL 32217 (904) 419-1010 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . REROOF Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4500 Expiration Date . . 3/30/11 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 79 . 00 79 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 1`tLtC,d BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: a RGtO6 Lodi �410n�,C ?6 ,h �1_1_5-3 Permit Number: -( 2z) g P _ R?C " Parcel# Legal Description -1 g S -agF_ PIP P►r f { � , (�(�,/. Floor Area ot Sq.Ft. I Sq.Ft Valuation of Work$ Proposed Work heated/cooled non-heated/cooled 1d g Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial esiden If an existing structure,is a fire sprinkler system installed? (Circle one): es No N Florida Product Approval# EL Li 7'7 For multiple products use product approval form _ ^ Describe in detail the type of work to be performed: re�-rr��1) Property Owner Information: Name: lrns- (FItzQ4e4_h )_)6Qs Address: q)-a csotan j2d City /I 00it_ j (ih State rLZip 3 3 Phone 9CJ�-1 -(p�7 E-Mail or Fax#(Optional) Contractor Information: Company Name: n�S Qualifying Agent: PIYIC/!' G f"7. ES� Address: G City C k State_e Zip .tea 1 Office Phone - - Job Site/Contact Number N # State Certification/Registration# Architect Name& Phone# 1� 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 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 period 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, urnaces, 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. I hereby certify that I have read and examined thisapplication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether spped ted herein or not. The granting of a permit does not presume to gave authority to violate or cancel the provisions of any other federal,state,or local iaw regulating construction or the performance of construction. 1_s4nature of Owner Signature of Contractor , � Print NameAS���reata��b�ltltttt� tit�t `�•''° �1.E . ly °ri,, Print Name ....1..t.. .!' �'?�R �......... ... .... . \.... ..55.,..E .� Gt tC.............C� �' �,�Gp� 24 NFfA»'t� •'6©� 24,0 S 5 Sworn to and subscri d be ore e r ; , av 20, Swo to and subscr ed before me s •y \aY °�,� . this Da of _� •2� �v "9m 1 �,, _ this Day f 0 '� "'+ :*_ /�� '� #DD 995030 o #DD 995030 ;oe Notary Public 9y:� ndedthN Q Notary Public '��9�'•. ey aid' O 7 /��iiB�� ►i�ii�ii����` Revised t�1't �P��°�•�` Doc # 2010229083, OR BK 15383 Page 856, Number Pages: 1, Recorded 09/30/2010 at 03:44 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. THE UNDERSIGNED hereby gives notice that improvements will be made to certain rcsi property,and in accordance with Section 713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT. l.Description of property ftar dvcrlplfo): -a PT ! 1931 C6 a)Shroet(job)Address: 2.Genersl description of improvements: f 3.Owner Information a)Name and address: , CG�h� x.133EInboAnRL b) Name and address of fee simple titleholder(if other than owner) &/I) c)Interest in property 4.Contractor Information n a)Name and address:��CQ AnG d �r RI" i y, Ll� SOORokd6n1201 Z9ft.�e1U14, b)Telephone No.: r N- •! -/01 D ( Fax lidd.(Opt.) I -/ S.Sw*V Information a)Name and address: b)Amount of Bond: c)Telephone No.: Fax No.(Opt.) 6.Lender a)Name and address: N 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: NV b)Telephone No.: Fax No.(Opt) i 8.1n addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(I)(b) Florida Statutes: a)Name and address: a b)Telephone No.: Fax No.(Opt.) 9.Expirstlon date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date is specified): WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, FLORIDA STATUTES,AND CAN 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 FU ST INSPECTION. IF YOU INTQTW� AIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK YOUR NOTICE OF COMMENCEMENT. �'? IMISS/p�•� �� srATE of rwahuA ? f i�t 2�,?0 �g;�9 COUNTY OF PINELLA.S *.� �iS ✓tO. w. z Signature of or Owners Authorized Orflav/Directer/Panner/Man or ODD AAj5' Print Name The foregoing instrument was'd t �efore me this A day of 20�by _1 rz6OU4 1-60S as /)Id)n_0'r (type or authority,e.g.officer,trustee, attorney in fact)for (name of party on behalf o w m trumeut was executed). Personally Known_OR Produced ldcntitication r Notary Signature Type of Identification Produced I la id LE!I U7 f I iQ/i7S2 Name(print) �1�illr,/�e �•�IIEC� OR Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,l declare that t have read the foregoing and that ii the facts stated in it are true to the best of my knowledge and belief. taaMsmcc,r„moto Signature or Natural Pelson Signing(in line 9 10-)AN)" 3