Permit 2277 Seminole Rd Unit C 2010 replace roof It CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
±} ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001503 Date 12/29/10
Property Address . . . . . . 2277 SEMINOLE RD UNIT C
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6300
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Application desc
Replace Roof FL 101 . 24 . 16
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Owner Contractor
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PEPPER, BARBARA NELIGAN CONSTRUCTION (ROOFING)
2277 SEMINOLE RD UNIT C PO BOX 49249
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 247-3777
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6300
Expiration Date . . 6/27/11
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 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: �aa-7-7 5em s nolP_1,L C 4 lkan�tc.�ce( c k FI 3d;4ermit Number:
Legal Description AG 3-1-aS -aqU-1 ewggsGrc t ;�f D Parcel# me11090 34 q - no�3 O
Floor Area o q. t. q.
Valuation of Work$ 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/pro osed structure(s)((circle one):_ Commercial esidential
If an existing structure,is a fire sprmhler system installed?(Circle one): o N/A
Florida Product Approval# P L�o ' 0, ti 5 :cLrir,
For multiple products use product approval form
Describe in detail the type of work to be performed:k®c,V ,n��s�c-mpc�
Property Owner Information: j
Name: Ck;V�- _�e b per' Address: 2,'a_17 Setnino\e RAL
City A-� be-'CLJ6 State Zip1��9,la Phone (��15 141a-��q�
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: �i 1-LC- Qualifying Agent:1_wsl�,CA a 1::)Address:2.b.f6c,K W City lye, 1',C',Xrk\ Stale 'F ocA c, Zip 32.Lta
Office Phone '"ol (P-l S qS p Job Site/Contact Number 5 eq-f6 1 o 0 Fax#
State Certification/Registration# CCC 139,5 r-6 R6 F�
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 eriod of six(6)months at any time after
work is commenced I understand that separate permits must be secured for Eleetrica!Work,Plumbing,Signs, Wells,Pools, tFurnaces,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.
1 hereby 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
type o work will be complied with whether speci ted herein or not The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
f �
Signature of Omer Q Signature of Contractor
Print Name Print Name ' T
....................................
........................................................
Sworn to and subscribed before me Sworn to and subscribed before me
this aIR_Day of 201 O this _2E Day of 7Dec�--mhec ,20 i o
1�e t l;z 1
NoYary Public Not
MY COMMISSION#DD973752 51 5 C.UZ aBEf" ' NNE LAN(MLE
EXPIRES March 22,2014 .*1 v-,y COMMISSION#IW799P 1.26.10
Sea otR I FkwideNolarySeryloexom EX"IROS March 22,2014
�.' FN-id,-W tarysenia..00m
d 'I 54158 Page 114.
Number gages: 1
NOTICE OF COMMENCEMENT Recoraea 12 29 2ot,3 at 09.30 AM,
JIPI!FULLER CLERK CIRCUIT COURT DUVAL
CCUNTY
Permit No. RECORDING$10.00
Tax Folio No. I(p 9)
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
1.Dcscription of property(legal description): :3�_ aS-• 9 4 a D A-. e,
a)Street(job)Address: a a 7 7 5 e m�n n je2d C Ai lan Inc. ?)rc•c 1n PX 30sa 21
2.General description of improvements: 12,0 i?�►�\c �� >�k
3.Owner Information
a)Nameand address: \ •�z\� > ; i��T ��.Z i
b)Name and address of fee simple titleholder(if other than owner)
c)Interest in property
4.Contractor Information
a)Name and address: t t � c1✓11� ��r,c1.L\L ��. o+CLtg�.��1 ,lr�ck�c„ 1� I1.3 �
b)Telephone No.: �yGll- ;2�� \5=►ec _ Fax o.(Opt.) cta,S) � ,- �► t ti
S.Surety Information
a)Name and address:
b)Amount of Bond:
c)Telephone No.: Fax No.(Opt.)
6.Lender
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.)
8.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 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 I,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 FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA
COUNTY OF PINELLAS 10,
Signature of Own r or s Authorized Officer/Director/Partner/Manager
e�� r
Print Name
The foregoing instrument was acknowledged before me this a day oft_ >t ,20\O ,by �
as (type of authority,e.g.officer,trustee,
attorney in fact)for (name of party on behalf of whom instrument was executed).
Personally Known OR Produced Identification Notary Signature 1
Type of Identification Produced Q�J lin(-C�"a Name(print)
1) 1 v6 vB+o 5 OR
Verification pursuant to Section 92,525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that
the facts stated in i in jhc(list„ belief.
S"" ELIZABETH ANNE LANGILLE Y
FORMSNOC,rvW2010 -'; •': MY COMMISSION#DD973752
EXPIRES March 22,2014 Signature of Natural Persorf Si ing(in line#10.)Above
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