Permit Roof 315 20th St 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001700 Date 2/23/11
Property Address 315 20TH ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5600
Application desc
REROOF 1956.3
Owner Contractor
CLEARY, ROGER A TO Z REMODELING (ROOF)
315 20TH ST 131 S WILDERNESS TRAIL
ATLANTIC BEACH FL 32233 PONTE VEDRA BCH FL 32082
(904) 241 -9921 (904) 273 -7042
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 80.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5600
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 80.00 80.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 84.00 84.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I LAi r„
.yJKl! f t r / 7 AO
1 1 l (J
CITY OF ATLANTIC BEACH .
ROOFING PERMIT APPLICATION
Date: (IX / 3212-Z8
Job Address: 3 15 Z O ��. $ C � /
Owner of Property: WO V Gle erg 2
Address: 3 / Z d - Telephone: Z///' 55'6? `f
Al d Z r emy D `c/L: 6- 4. Mrs v �
Roof Contractor
/ �G�hi9.State License Number: 6 ce., / 3 2 I Z2
Contractor's Address: 1 - 5 \ ,. LAJ t 1 O eytN b S J 7r2e, ?c4 f A:1- 3 2.0 Y 2i
Telephone:, Z? 3 ) -) 4 Z Fax: 2 3 - ' 1v4 Z-- Email: R 41 g /G ' Cd/1
Scope of Work: /? A: Roofing Material TA.�t k 3 c� 4 1� G
E 1L54 . 3 sj,WL4&s
FL Product Approval # Valuation of Work: $ 56 00
'L. 1 it I71 9 Pell' l2-S7-/e )2
Required Inspections: Sheathing /In Progress -Dry In / Final
If re-roof: Assessed Value of Structure: _ < $300,000/ >$300,000; Roof -to wall improvements required?
( Applies to single family structures only)
'WARNING TO OWNER: YOUR FAILURE TO RECORD 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 B RE RECORDING YOUR NOTICE OF COMMENCEMENT"
' SIGN ATURE OF OWNERy- � ., D Ke " . _,gate: ' - C1- 1
AS TO OWNER: p
Sworn to and subscribed before me this 1 day of "40-, , 20 11 .
State of Florida, County of Duval 1
MARJORIE M. ADAMS- F�pNotary's Signature %3.). - Ft. \1\ C.,,Ck1k.r�.D \ c - �1
NOTARY PUBLIC 0 Personally known
f STATE OF FLORIDA 4 k . Produced identification
. Comm# D00933778 Type of identification produced -n- Y..7t %Ot i °› ‘...V.-.
- , Expires 10/30/20
SIGNATURE OF CONTRACTOR: -. Date: 279/
AS TO CONTRACTOR: Q
Sworn to and subscribed before me this -1 day of.b , 201\ .
State of Florida, County of Duval \
Notary's Signature: 1%� - N 1k..... Ii.z. a- , ___ .
Personally known '
MARJORIE M. ADAMS -MARR W 0 Produced identification
NOTARY PUBLIC Type of identification produced
-' `` ` STATE OF FLORIDA
♦"" �' �; Comm# DD0933778 800 Seminole Road •Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 • Fax: (904) 247 -5845
Expires 10/30/2013 F: \roof permit applicaton.docx 7/28/09
MAR -1 -2011 10:54 FROM: CLERK OF COURTS 904 270 1512
70:92475845 P: 1'1
i / .. / 7D0
NOTICE OF COMMENCEMENT L (� ( � J
N Tax Folio No. a U
..•
Permit, No, AO _. County of Duval
iDi M AR 1 ;. 20 11
_. State tY
THE UNDERSIGNED hereby give noticc that the improvement will be made to certain. real property in accor' cc with
Chapter 713, Florida Statutes, the following information is provided in this Noticc of Commencement
1. Description ore ns legal description of property and address if available):
315 K _.14171.0 -n ai e. Bch r F L
c I
r o 2. General Description o f improvements:
G p�vf
r c" 3. Owner Information: Cleo, r 3 �� c 2 � ap Tic °'�
, �' !: n) Name and Address: D G 6., ,r 0 i s h) Interest in p(operty' 0 /- 4 3 .?.T 7
A . • o: c) Name and a of simply titleholder (if other thou owner):
_..:te, r —
4. ) Name Address: t Q /-7 2 , e 1 / . x _1 3 � 20 AK,_&,s,st .
.�' a c ` to r r a Name and /f G G .• l•'•� �� Di./ - g rti n- 3 -7 th f A
n " ` r b) Phone Number: ;re Y .? 7 •
., ci. , , f i 5. Surety Information:
..� l.> a Phone Number: - -- - --
oa) ,, a Name and Address:
7 A' ' r..) fC; h)
c) Amount of Bond: S
6. Lender Information:
a) Name and Address:
h) Phone Number :
7. Person within the State of F lorida designated by owner upon whom notices or other documents may be served as
provided by 713.1,3 (IXa) 7, Florida Statutes:
a) Name and Address: - i
h) Phone Numbers of Designated Person: - -- --
R. In addition to himself/herself, Owner designates
of to receive
a copy of the Lienor's Notice as provided in Scction 713.13 (1) (b), Florida Statutes.
a) Name and Address: 1 a
b) Phone Number of person or entity designated by owner: _ —
9 Expiration date of Notice o ;Commencement (the expiration date is one (I) year from the date of Recording unless a
different dote is specified(____ -
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF TI-IT
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CI IA,PTER 713, PART
L SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING 'TWICE FOR
IMPROVEMENTS TO YOUR PROPElfIY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
INTEND TO OBTAIN FINANCING,
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU a
CONSUL WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING 'WORK OR RECORDING
i••,, YOUI 0 OF C• .. •.c:•NCEMENT (��,( ,� ��
• w / 1Z]_�.3.�t3�..
Sigoatur9f'Ovine , Ownees Author' ed Officer /1)ircctor/Partecr/Managcr Signator s Printed Nam & itle/OfEcc •
Thc foregoing instrument was acknowledged before me this Q l day of h , 20 20V , by • R t e.o►ty as .. , for
(N of Person) (Authority Type, i.e Otlicer /Attorney) (Name of Parry Instrument was Executed for)
MARJORIE IA ADAMS ARIWP rU lJr \._ - ,` —
NOTARY PUBLIC NOTARY PUBLIC, STATE
.. OF FLORIDA
Print ,S` Qch`+-Aattlw `
STATE OF FLORIDA .
•�" `t - � ` Comm# D00933778
0 Personally Known
' • .,F ' Expires 10/30/2013 •
Qldcntificat /Type'',- 1l��t�cS x`aC
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 1 declare that I have read the '
foregoing and thatthc facts stated in it are true to the best of my knowledge and belief.
Signsmre of Natural T'erlo7+ Sienine, Above
Revised 10/1/2009