Permit Roof 379 Belvedere 2011 s CITY OF ATLANTIC BEACH
.0 800 SEMINOLE ROAD
i t s` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001716 Date 2/23/11
Property Address 379 BELVEDERE ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 6200
Application desc
REROOF
Owner Contractor
OLLER PHILLIP ANDERSON BUILDING RESOURCES
379 BELVEDERE STREET 1541 CEDAR BAY ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32218
(904) 707 -9703
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 85.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 6200
Expiration Date . 8/22/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
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
O ffice (904) 247 -5826 Fax (904) 247 -5845
Job Address: J 7 /3( o"(ve 5 Permit Number: / I ( 1! Y'
Legal Description Parcel #
• / Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ (0 �'' 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 g/proposed structure(s (circle one): Commercial Residential
If an existing structure, is a fire . rinkier L stt e m installed? (Circle one): Yes No N /A 6,
Fr o o
u p odicts use t o ro al f
multiple p acts se r-( p ncpprov arm
Describe in detail the type of work to be performed: fi r ' c /
Property Owner Information :
Name: Address:
City State _Zip ' 33 Phone c\ G V 3
E -Mail or Fax # (Optional) S?y \ �= 9 vNN
Contractor Information:
Company Name: Ce f -- /c `, j/ Qualifying Agent:
Address: S 7 (/ CG " e -'r r f (f City `T State /_'/'S Zip
Office Phone 7 7 S 7 ? Job Site/ Contact Number S ? 7GI ? Fax #
State Certification/Registration #
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 1 ce trfy that no work or installation has commenced prior to the
Issuance o a permit and that all work wilt be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void ifwork is not commenced within six (6 months, or if ct straction or work or abantkv ed,/or a of six (*9 months at any time after
work is commenced. I understand that separate permits must be secured for Work Minding, Signs, Wells, Pools, 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 1 have read and examined this ication and !mow the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether spec r ed 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.
•
Signature of Owner S>, 4,v a • Signature of Contractor,, _A
n Sty
7/t4.4_-
Print Name c? �- �� • � � , c� \�, .� Print Name DO/ D �/�U�� (� ......_
Sworn to and subscribed before me Sworn to and subscribed before me
this Day of , 2 a ' , 20
d 7/ `` " ° "' �f t
LYNETTE KLINGER // ,
LYNETTE KLINGER e
Notary '�'P -? _
ommission ' •r. • • ��./..•✓ , k'/FIllic's, ..: r.rr • •
My Commission Expires
�f ` ! A My Commission Expires
as. A 06, 201
��,.�` April 06, 2014 "'���� ""
p • # 1.26,10
NOTICE f/iF COMMENCEMENT
f FREPAF.E ¶:4 7:if:-ICATE)
Tax Folio No.
Stale tate Permit of No. County of
S
To whom it may concern: and in
The undersigned hereby informs you that improvements will be made to certain real property,
accordance with Section 713 of the Florida Statutes, the following information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
9 i' C/l Ct'
Address of property being Unproved:
, LAC
General description of improvements:
Owner
. H11/ C `-
Address 7 7' / e- ( f � . �. c=
Owner's interest in site of the improvement
Fee Simple Titleholder pf other than owner)
Name
Address
00
v�
Contractor / /' ,r L i
Pho t Fax No.
Phone to No.
Surety (if any)
Amount of bond S
Address Fax No.
Phone No.
Name and address of any person
making a loan for the construction of the improvements. •
Name
Address Fax No.
Phone No.
Name of person
within the Stale of Florida, other than himself, designated by owner upon whom notices or other
documents may be served: •
Name
Address Fax No.
Phone No.
In addition to himself. owner designates the following person to receive
a copy of the Lienor's Notice as provided in
Section 713.06 (2) (b). Florida Statutes. (Fri in at Owners option).
Name
Address Fax No.
Phone No. a
Expiration dale of Notice of Commencement (the expiration date is one ( year from the date of recording unless
diferenl date is specified): OWNER THIS SPACE FOR RECORDER'S USE ONLY GA T — .
sae
I
Recta me . +P p-weC
ti Doc # 2011042218, OR BK 15523 Page 1126. �� �., -+;� +'F'—
Number Pages. 1 ' 11-n ! ` Commission N DD 979707
Recorded 022320 at 01*03 PM, _* �f o Commission Expires
JIM FULLER CLERK CIRCUIT COURT DUVAL ?a.n�,,.r April 06, 2014
COUNTY —
RECORDING 510.00 v.. . Co
e onso m Laiga- '
.tl cGmmKSIan exports: Al 1 .� - r • .v.