Permit 35 Forrestal Cir N *mF
04PAn mir OF ewL0#NQ
lTYOFATLANncbEACH
0
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L
PERMIT NiORMATION aL C RC14
Addrets"', FORREST
#,ormi t""'Numb* 1, 15632 35 PLOR10A. 3121233�,:�
LANTIC Asacs
AT
--------- LZOWD96CAIPTION:
of Work.Reoail ��01
Blockll Lot-.14
v
o sub
C'd`list r ' 'ijpe-�POOD FRAME Rn-
ed
Propos seiSTNOLZ FAMILY
Subdj,'v' si®rn,.ATLAKT'C BEACH VILW
Dwelling$*- 0,
,j
E$t 'VIA 10. 0.
2 000.'00 "
Amprbiv.- Cott:
30,00,
Tota
30.,00
e
S
64R g
DOOR;f 14OVE WINDOW,ADD DOOR TO REAR OF
Work IQ
APPLICATION F
J0.00
TON
11, 1
IRCLE NORTH
op
pLORIDA 322,1 . 50
10
9
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-Name� 'p
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NOTES'
5
TLEASt 24 HOURS PRIOft TO-IINSPECTION
NOTICE INSPECTIONS.- MUST,0E REOUSSTED A;
RUBBISH AND DEBR I IS 6RK MUST NOT'81: PLACED'I N PU sLic SPACE,AND.MUST OE
SUILDII G MATERI�L I FROMJHIS W
C I L.EARED UP,AND H 6 Au LED AWAY BY EITHER CONTRACTOR OAnOWNEP
E 'LAWC -"f
'THtrr AN '$U4'T-rj,
)LY WitH ECHANICS' LIEN
,OWNER: AYJ MP
NT
'E L0040 I ROVEM
Tfi
OCNIION��'PM",_I
:D:rPILANS WkJCH,.AkE'0ART 0 PERMIT AND SUBJECT To Rtv
ORDINGTOAPPROVE
OF APPL
UED AQC
ON
ICApL,E�PA ION A
VIOLATI $�OF,L �W-6
NG 6EPARtMF T
ATLAN 0 g
T1 'A' ACH BUILDI
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS
MOVING,DEMOLITIONS
Owner(s) : 0 1 -5 C . 71-�� IQ A) 16-19/1/
Address: Fo r(.9 e S 7-,4�- 0 IP, Al
2jel�4 — �- O S�-Y-� �--2770-57 3
Lot # ILI Block or Unit # Subdivision: o*T-1— 13cA- VILJ- ff
Contractor:
State License #
Address: Phone No:
city State— Zip Code
Describe work to be done: A �'-'� —4-11�
Present use of building:
Valuation of Proposed Construction:
Proposed use: V2
Is this an addition? /-) 0 If yes, what are the dimensions of the added
space: ft. X ft. Will the added area be heated and
cooled? New electrical (or increase) ?
New plumbing fixtures? New fireplace? New Heat/AC?
SVBMIT THREE (COM4ERCIAL) TWO (RESIDENTIAL) =WLETE SETS OF PLAms, INCLUDING
SITE PLAN, SETRVEY, ENERGY CODE FOEMS, NOTICE OF COMENCEMENT, AND
OWNERIcoNTRACTOR AE71DAVIT, IF OWNER IS CONTRACTOR.
Signature OWNER: c::K Date: 1-2-131
7
V
Signature CONTRACTOR: Date:
Sworn to and subscribed before me this 3 day of Y7
RECE/VEDNOTARY' PUBLIC STATE OF FLORIDA AT LARGE
PaWda Amonft
n,FC 3 1997
W WW&SSMf==I EMFWS
AuWvA 27,M
CitY of Atlantic Beach
Building and Zoning MWO TM TM FM W.MMM.M,
__A6 lie
CITY OF
ge=41 — 4
--- (' 13 1. FLO
�VFLANTTI )11
1 WN I,'
F.\N 90 1, t 60.5
CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REc)UIRES OWNER/sUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES:
STATE LAW RE(:)UIRE:S CONSTRUCTION TO BE DONE EBY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT
UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY. TO ACT AS YOUR
OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE: - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND
OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING,YOU HAVE BUILT YOURSELF
WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE: OR
LEASE, WHICH IS IN VIOLA-MON OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.
YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR
RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY
COUNTY OR MUNICIPAL LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER 70 IMPROVE THEIR OWN PROPERTY WHEN 17 IS FOR PERSONAL OR FAMILY
USE, AND LIKEWISE REOUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) BE UNDER A BUILDING PERMIT AND PASS
ALL NORMAL INSPEC71ONS. HE ORDINANCE s-rA7ES OWNERS MAY PHYSICALLY Co WORK 7HEMSE:LVES; OR MAY HIRE
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF 7HE OWNER, WHO MUST BE ON
THE JOB AT ALL T7MES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES N07 ALLOW USE OF'
UNLICENSED CONTRAC7ORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOIAEOWNERS INSURANCE POLICY CLEARLY PROTECTS
THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR
FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE: No. 455-225(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE.
THE: OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE: OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CF-FrriFicATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247-
5826) IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE: DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL
THE REOUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
PROPERTY OWNERWUILDER
ADDRESS TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS 3 F/
NOTARY flUE3LIC;
NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPIRES:
ARE EMPHASIZED BY THE BUILDING
patdcla AmonflM
DEPARTMENT. C&&MI EXPIRES
my COMMISSION#C
August 27,2000
BOWED TKRU TROY FAIN INSURAKE,INC
RWB Construction, Inc.
1660 Blanding Boulevard Jacksonville,FL 322 10 1'elephone(904)394-0033 Fax(904)384-0058
PURCHASE ORDER NUMBER PURCHASEORDER
PURCHASE ORDER DATE: JOB:
VENDOR BILL TO SHIP TO
NAME NAME RWB Construction, Inc. NAME
ADDRESS ADDRESS 1660 Blending Blvd. ADDRESS
ADDRESS ADDRESS ADDRESS
CITY,ST.ZIP CITY,ST,ZIP Jacksonville, FIL 32210 CITY.ST.,zip
CONTACT CONTACT Richard Helster CONTACT
PHONE PHONE (904)384-0033 PHONE
ORDERED BY REQUIRED DELIVERY DATE
SHIP VIA DIRECTIONS
TERMS
REFERENCE
UNIT EXTENDED
QUANTITY DESCRIPTION PRICE PRICE
7 7 194, 07
X rek 104 41-K (ru Bes) q6
0 Aff�J N� 6: j1,4A;,ZE-b A1441-S
K X
--2 K
C- AR-)4Z-E
-510EM6
.F9AWe-- AAJb Azoe 5,00 . 00
AA)b 1�5-0- 00
FAM / 570- 00
A A[b j
�5 j
AF
XF7 AM,1�444 64�,r7 JOP) 5
SUBTOTAL
SIGNED SALESTAX
For RW8 Coristructio.41-- SHIPPING&HANDLING
6WfJt—:R 5HOPP11)& Fooe A)0T IAAUU,)e�) TOTAL 1-3m
F- MAP "'11-10WING SURVEY OF
Aj'1J)M'rT(' 11F.W11 III I-1,A 1,11Q)T TY I W; PAGE,
(,F 1111V,11,
RECEIVED
OEC 3 1997
antic Beach
City Of Atl
Building and Dning
'ji
fir
Q)
1-z
4z
MAP SHOWING SURVEY OF
LOT 149-BLOCK 19 ATLA"IC BEACH VILLA UNIT NO. 19 AS RECORDED IN PLAT BDOK 30t PAGE 56
OF THE CUMMT PUBLIC RBCORDS OF DUVAL COUNrfs FLORIDA.
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DEpARTM9NT OF BUILDING FOR OFFICE USE ONLY
Date 19
Clvy�.Or ATLARtIC BrAcH, FLORIDA
----------- Permit # Fee
Ap cation for Permit Valuation
tiot Misc.. Alterations House
and Repairs
DESCRIBE: 774
'building, erect awnings
Astate if to, repair, alter, add to or move
or- signs, etci.')
Sub.Div.
Buildi Blk No.
ng on ilot__No.;Oe��/ 7
j
Address ;,-Poe 7� Valuation
Owner's Name S Z10i 0 I:s
BUILDINGS & OCCUPANCY
Building Use Residential or Business
don-71
What Plumbing work to be
Size of Present Bldg. Size of Extension.
Lot size Material of Roof
No. of stories now after altered
'Material of Present Building
Material of Extension
PkMS,,.MUST BE §UBMITTED RKrEW�tTll
SIGNS
Size Classification
(state whether ground, roof, wall, projecting
banner)
Material of Construction
Illuminated? Type of illumination
(State whether larnpa or neon)
Will sign be over public property?
SUBMIT DRAWING SHOWING CONSTRUCTION OF SIGN AND METHOD OF F.W�.JNG
WRITE ADDITIONAL INFORMATION BELOW
(For canvas awnings provide dimensioned drawing on reserve side)
SiORTAyt�'JJOTICE:
�*deration of permit given for doing the work as described
statement, we hereby agree to perform said work in
th attached plans and specifications, which are a
in
accordance with the building regu
lations of the
Z.;
Beach d 1, Bui3,din%/Aode)
...... th a rg
,0,9,u ern Stan
r
---- --- or Owne", 0
Aone
-Z2#42
MAP SHOWING SURVEY OF
IA)T 14t 'BLOCK It ATLANTIC BEACH VILLA UNIT NO. 1v AS RECORDZD IN PLAT BOOK 30t PAGE 56
OF THE CMMT PUBLIC REWRDS OF DUVAL 00UNTY, FLORIDA.
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777
06PA10V 4T Of BUILDING
CITY'Of,'ATLANTIC 8 ACH
OeRxxt ItiroitnATION
------- LOCATION I FORMATION
-P
Wait numbers 5575 Addreast 35 PORRE, TAL CIRCLE:
T
1�-Perl *it Type i' Rk-RbOP`� A LA1RTIC H's' ' PLORIPA 32213
'Olean of Work t )NEW ---------- LEGAL b1WCRIPTr0R
rConstr., Typw *wWV FRAVICK Lot i Slook; Sectiont
Use$ ST.WaLs, PA14ILY Townxh*0;z RNG.- 0
' 0
i4ellings t I Codv,% , Subaivin*oft S"
$0.00'
A22.50
*2Z50
SZ29/92
#22F WITH WODIPIED SITUXMEN
T PPLICATXON FEES
"A
Xojj
A
'PERMIT $22.50
WAT
T*L CIRCL IMPACT" FEE $0.100
*00,
FLOR9 04
tx-
P
RADQ0:, G
OAS' $0.00
100ROAT RA
WATER TA# .00
Uv coil 100
TAP" 00
7
IL4 HYDRAULIC SHARE, $0.00-
IL,4
FL 3�1i6
)Li Type*: �o kz:-titSik& �Prt 00
SEC., H IMPACT FEE loo
77-7� :
NOtiCIE.-Att.CON,�REte,fOftM$At4o�FOOTI140s,musT,$Elloi.8,Pe, 84FORti POURINe
CTFE
PERM T VOID,SfX�MONTHS OTER DATE-OP IS$,U
�$,IUILDJNG MATF.RtA Nb,DiSAS FRO14 T IS WORK MUS NOT�B PLA ED IN PUBLIC SPACExAND MU*r sE ,,
T
-CLEA ED U
0 A�kb H t A VTH Ek CONTRACTOR OR OWNER.
D- A L 0
NICS," 9 WL
CAN A --'S T- 1,
'VE W,
44 CHA UE,
FAMUR b-CO
N,
�"SPROPOTI�0���PAYIWMICE BUILDIN I g,",:M
;0414
4 AT
G,'TO APOROVi6,PLAN,$'WHItH ARE PART OF THIS PEFkMIt'ANr) '6601 �F!
AUE, ACCORDIN
OLATI F PPL CABLIE ROV LAW.
0140 A, I P i$1ON6 OF,
VWT
IPT
LANTtC BEACH BUILDING DEPARTMENT
CITY OF ATLANTIC BEACH
PERMIT APPLICATION ROOFING
�jowner(s):
Address: TA
F,Phone:
Lot # Block or Unit # Subdivision
Contractor:
Ct,)F -Phone: 0
Address:;rZ9q 1,3_
State License No. ccco�(-(40
Describe work to be done:
Materials to be used: TrUP17
Signature OWNER: * te:
Signature dONTRACTOR n
V
ATLANTIC REACH,FL 32233
INSPECTION PHONE LINE 247-5826
D
Application Number . . . . . 05-00031184 Date 9/09/05
Property Address . . . . . . 35 FORRESTAL CIR
Tenant nbr, name . . . . . . 1CU 1AH
Application description . . . MECHANICAL ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------ ------------------------
JERNIGAN, L.C. OCEAN STATE HEAT & AIR
35 FORRESTAL CIRCLE 1476 ATLANTIC BLVD.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 249-8251
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . -
Permit Fee . . . . 63 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 63 . 00 63 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 63 . 00 63 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES-
Hu FI L
Z3m
CITY OF ATLANTIC BEACH
MECHANICAL PERMIT APPLICATION
Date:
A ..
,� /I-
Property Address: - 6,41
Owner: A-�11 Telephone 9:
Contractor- ocean�rn-4T a---T-e- RC I F' Q I C Telephone 9:Ewl-SE51
Contractor Address: 14-1(P G:TLn11Uj'C,(-)fy' A n8 Fax#:Fd1q-9Qqq
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance
with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of
good practice listed therein-
Type of H atin Fuel: If other construction is being done on this building
77ectric or site,list the building permit number:
• Gas: —LP —Natural /Central Utility
• Oil
• Other-Specify_
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
Heat _Space _Recessed -,�Central —Floor R""Residential
Air Conditioning: _Room _yCentral
Q, Duct System: Material I Thickness U Commercial
Q Refrigeration Maximum capacity_cfm :1 New Building
2 Cooling Tower: Capacity gpm 3--�Existing Building
C2 Fire Sprinklers:Number of Heads
Q Elevator: —- Manlift Escalator_(Number) 5-*`lReplacement of Existing System
u Gasoline Pumps —(Number)
:1 Tanks (Number) Q New Installation
Q LPG Containers (Number) (No system previously inmalled)
zi Unfired Pressure Vessel ED Extension or Add-on to Existing System
U Boilers
�2 Gas Piping 0 Other-Specif�_
cl Other-Specify_
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving
Number Units Description Model 9 Manufacturer Ton's Agency
/I / 1;?
GAC PHI ;i
M-n U do
W
HEATING-FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving
Number Units Description Model Manufacturer BTU's Agency
:;App,ovmg
Ag L
�5FU _y
T mt:�NACES,BOIL
rNu�b Ge, Decj�
/WX1
TANKS Norninal Capacity Type Liquid Serial Approving
How Many &Dimensions Contained Manufacturer No. Agency
goo Seminole Road - Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 . Fax: (904)247-5845 - http://www.ci.atlantic-beach.ft.us
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 08-00001207 Date 9/04/08
Property Address . . . . . . 35 FORRESTAL CIR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
----------------------------------------------------------------------------
Application desc
roof f125333 . 1 and 3
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
JERNIGAN, L. C. NELIGAN CONSTRUCTION
35 FORRESTAL CIRCLE PO BOX 49249
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 247-3777
----------------------------------------------------------------------------
Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 3/03/09
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 60 . 00 60 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLAUM EF" 08-
OWSMWXXE ROAD ATLANTIC SEW-K FL
-MIM;MT
OFFICE- -SM*FM NO.AVOW-a8ft
191.11LOING.-DEPTOCOARLIS
BUILDING PERLST APPLICAMN DUVAL COUNTY
'LJOBADORM
'77
—77 tj 00
RESIDENTIAL
13 NEwis Li [3oBxxffm
LOT_EXOCK_SWDIV0ON OADorrm 13 comwERym usE 13 COMMERCIAL
E IMEE
33 ALTmTm 13 AccEssm eLlor.
03 REPAIR 0 POOL/SFA 0 yes 0 WA
0 E W
3 MOVE 0 OTHER ONO
_777�
77�
9.NAMF_ 15L COMPAW NAME:- 23,COMIPAWNAME.
IVIFL,)bA-Al CO3j:5'TJ?14T*W
I&NAME: 214,LICENSEE NAME.
3 jtAoJ Ai A-)6*,AJ
10,ADWESS:3 IT STATE OF FLORIDA LICS)SE NO.: 25 STATE OF FLORIDA LICENSE NO:
ca 13 9 f9j ICA 0r9.$;
P'Tt- FL_ I&AOORESS:?0 ,ffqv4 ttqL19 26,ADDRESS:
-T.g. a 4 0
11.OFFICE PHONE. NO.: 19.OFFICE PHONE FAX NO-, 27.OFFICE PHOW FAX NO.:
-t 41 -.%71-7 N 4 7 -11
13.CELL PHONE. 21-CELL PHOW 20L CELL PHONE:
r4% --9 7 c,6
14.EMAIL ADDRESS. 27 EMAIL ADDRESS: EMAIL ADDRESS:
T10'130V, 6 D,.-t4 f 4 1 v W n&wq
31.NAME: 33.NAME. NAME.
32.ADDRESS: 34,ADDRESS: 4.6,jX).*35_ADDRESS:
— 131,1
Application is hereby nude to obtm a permdto doglewortt and irabladons as ' Icer* t0nowultorinsh0efionhas
comrnenoad prw to the Issuance of a pem*aid to an vmxk vA be parkinned ID nod ft slaindsift of al hm requielft conshuction in this
Jurisdiction. Tflis pern*beconles null ancl void If work is not convnenced witidn sk(M oncino or If consaMn or work Is suspended or
=bandoned for a penod of six(6)nxmft at arW*ne ailler wak is convnei I understand to i pg 1 We pennits must be secionad fiDr
Work,PWMMM Sign%Welki Pook�.Stwnscm.BaDws.Heallem TwAtel, Air Canddwow%o6r-
OME"AFRDAWT-I w*OW al ft ft"oing;lift,neft is acmireft and to all work vA be done in cm0lierm with al appft"
laws regula"Construction and zonft.I vA not occupy or use Ve refeirenoed buldingil or wN pwt tenlf,urd al irspections am linaled and
prW to obtainirM a cerfikaille of occupancy or conViellim issued by ft bukft of&*C as nxpAred by Ww.
At** WARNING TO OWNER:
YOUR FAILURE TO RECORD A 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
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEIff,
7, "iR
41,
h�
Skp"d: YaL.. Sqwwwk
Beftftrnegl� 0"dayd' JGO(f_ .2W in Ow owanly of dW,* 2W in the county of
Stake of Fl%ft has p a a r all) has
41-S ��hfli trr-t,��a Duv*9774
Wn by hknwg I herself ind affarns 9 "arx! anit harintsyll anif III am
true and accurale. 05:� om aw accullift.
Notary Public at LaW,Stalft Of county d Nol!!)�at Lmq^ d County d:il 0:�
13 Pegonally Known
qA*—dk*n@k*1on-/ Proamed
NO"Sig
y
16H
�Y L/)GRAHAM
SHVLE
N,
Notary 1:b�li'c�itraFIkorida
Ic AStalle of Florida
ubl wy Commission Expire 14,2010
Commission Expim Feb 14,2010 'Dire
Commission$DD 518533
CODAS jjjk%4EC,,,,CW0M'MT ission#DD 518533 4�,c,
Naftmf Notary Ann. Bonded By National Notary Assn..
NOTICE OF COMMENCEMIFNT
Permit No. Doc#2-OW226366,OR BK 14626 Page 2148,
Tax Folio No. Number Pages:1
Recorded 09/04/2008 at 02:53 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
State of Florida COUNTY
County of Duval RECORDING$10-00
TBF-UNDERSIGNED hereby give.notice that the impiiovement will be made to certain,real property in
accordance with Chapter 713,Florida Statutes�the following information is provided in this Notice of
Commencement.
1. Description of propert
y QegW description Of property ar address if VailabI2�
I - _ )d a'c�4 1 (—
(
2. General Description of improvements:
-1. Owner Information:
a)Name and Address: q "X/-1. ac 1,
b)Interest in property:
c)Name and address of simple titleholder(Wother than owner):
4. Contractor(Name and Address): HEUGAN CONSTRUCTION
5. Surety Information:
a)Name and Address: Jadmonville Bch, FL 32240
b)Phone Number
c)Fax Number.
�d)Arq�-ofBond----,
6. Lender Informatiow.
a)Name and Address:
b)Phone Number-.
7. Person within the State of Florida designaWd by owner upon whom notices or other docurnents may be
served as provided by 713.12(1)(a),Florida,SftWte&
a)Name and Address:
b)Phone Number:
c)Fax Number: Of
8. In addition to himseWherw1f,owner designates
to receive a copy of the Lienor's Notice,as provided in Section 713-12(1)(b),Florida,StaMm.
9. Expiration date of Not=of Commencement(The exph-ation date is one(1)year fi-om the date of
Recording unless a difierent date is specified:
Signature of Owner: ,-AA&g
I-
Sworn and subscribed before me this day of 20
0 Known PersonallyU46ihown:
Signature of Notary: iAg—
SHIRLEY L GRAHAM
My commission expi thdft-State
4-my Commission Expkm Feb 14.2]
010
'W
51MM
Commission#DD 518W
8 By Nabonal Notaty Assn.