Permit Roof 2247 Beachcomber Tr 2010 ' �
-e' - CITY OF ATLANTIC BEACH
�� 800 SEMINOLE ROAD
,5 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001407 Date 11/23/10
Property Address 2247 BEACHCOMBER TR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 11890
Application desc
REROOF GAF FL 1012416
Owner Contractor
BURGIN CHRISTOPHER & LAURA FISETTE CONST. & REMODEL (ROOF
2247 BEACHCOMBER TRAIL 159 19TH ST N
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246 -0309
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee 110.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 11890
Expiration Date . 5/22/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 110.00 110.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 114.00 114.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
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: 2 d� � 6.OlC C.A9 W1 beiV 7116ti
Permit Number: A • /47
`[2'j- DQ� qE clean Par cel# /G 4p3 U/
Legal Description � Qq �2�-�9 0�l `�7 0441 oor A rea o Sq.Ft. Sq.Ft
Valuation of Work $ 11 gjg DD 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 structures) (circle one): Commercial ' esidentia ►
If an existing structure, is a fire sprinkler system installed? (Circle one): ' es No N /A
Florida Product Approval # (raf< FL 10I'24 I f k FL Ill 15- For multiple products use product approval form
Describe in detail the type of work to be performed: - ,goo �)(451- -✓,C� oo I�
•
V
Property Owner / Information: 22_-- //__ _
Name: / ✓; h C r•• Address: - 7/ 1 -1 0 7 Z �7 j gg i v1 bp". ✓ Trot; l
City tier P P State Zip 3Z2 3; Phone a
qs oe,et
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: E*, ►'4 uc t o✓ d ZWzpc r`i Cf . Qualifyin, Agent: ) � S
Address: v44- City �..., 1 ' !i S tate Zi 5t ZS22
is � � � p
Office Phone (r 030 Job Site/ Contact Number 69 / - 06 ,0 Fax # 2 li 693/
State Certification/Registration # 6C6 - / 3297,9
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 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, ells, Pools, F 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.
r hereb certify that I have read and examined this . application and know the same to be true and correct. All provisions of laws and ordinances governing this
.pe of work will be complied with whether specd herein or not. The granting of a permit does not presume to give authority to violate or cancel the
2r oviszons of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Co c r .`.��
Q �
'Tint Name CC 1 uhli J Print Name 1'
Sworn to and bscribed before me Sworn to and subsgrib yd before me
his )S . Day Al ti E►'wt3'f11- , 20 ) D this r Day of NQ V t1III9f/Y , 20 ( f7 Aft
•— �__�..�_�� —rte ���� i. � 'i•
rotary Public ?+ ` 4 ya ot. 'ublic �r ORO
• — i . Notary Public - Ststt of FloddI F Notary PA* • M O M FM
My Comm. Expires Jon 16.2011 4 1M16!4lP WON f rN SN 21
• , . Commission • EE 11 N { _ Coawn On • E I
3A NOM Mal Mom. '�` NNM 1MwM NfEMnM
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 110 ` (e3 "d /Li
F
State of 0,4614 County of Dw VA,/
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real property, and In
accordance with Section 713 of the Florida Statutes, the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 411- .1. De • 15 .216 2q E
0 , LIB ocean walk- iin4
Address of property being improved: 1441 fj?,atd, Gown I,,v - read 441 h i 6•I• re.
322 33
General description of improvements: f % - /200
Owner /414S/2 AM/ 1a 4 gi N►
Address Ii __, .i ,I .•• .. l Z
Owner's Interest in site of the improvement (9(..m.,D/
Fee Simple Titleholder (if other than owner)
Name
e c) Address •�,�' �/
Contractor /Ke 1, ( ' 114,,v,Se'l a).
g •
Address , / 1% N' • • ' # L �i .6. --S1)
Phone No. 2W(r 07 Fax No. 61-8,03e
Surety (if any)
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition b himself, owner designates the following person to recelve a copy of the Llenor's Notice as provided In
Section 713.08 (2) (b), Florida Statutes. (Fill In at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date Is one (1) year from the date of recording unless a
different date Is specified): ( �.
THIS SPACE FOR RECORDER'S USE ONLY OWNER
DATE ill
Signed:
ti
Before me this 1 ly of tit. vot. Its jtie �'
County of Duval, State of Florida, hes personally apps
,,,,, , In by VALERIE faICEWAN•WISE
,
,;oc , . aft : herself and affirms that all statements and da• q Notary Public - State of Florida
e and accurate
Number images . • • My Comm. Expires Jun 10, 2014
Recorded 11 23 2010 at 0835 AM . Commission • EE 1198 JIM FULLER CLERK CiRCuIT COURT DUva'�
Boodod Through Nat omi Moldy AIM.
COUNTY
RECORDING 310.00 Notary Public at Large.Stp@ �� ' L ...4 . Cou 0
cmmrakeb res: ' t _4 \ i `•t
ersonall Known or
Produced [den cation