Permit Roof 403 Seaspray 2011 rj - .1 CITY OF ATLANTIC BEACH
' ' 800 SEMINOLE ROAD
e �� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001706
Property Address Date 2/22/11
T
Application type description ROOF PERMIT AVE
Property Zoning TO BE UPDATED
Application valuation . . . 7600
Application desc
REROOF
Owner Contractor
HAMRICK NANCY A.J. WELLS ROOFING
403 SEASPRAY AVENUE 5432 WELLER PL
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 90.00 Plan Check Fee .00
Issue Date Valuation 7600
Expiration Date . . 8/21/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 94.00 94.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
..... 11 x yr Pk I LAN LIC !BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: t{03 Scrip# - A -y pv... p ��w A 3 Number: /--�/ � 70&
Legal Description 1 0-1 to 03115 SALTAtQ _sec . 63 Parcel # 1 70`4?,2 -0300
Valuation of Work $ —
,� Floor Area of Sq.Ft. Sq.Ft
Proposed Work heated/cooled i15� ‘ n heated /cooled z t 1 2
F—Uu
Class of Work (circle one): New Addition teration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Restd _
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No' N /,
Florida Product Approval # Ft. - 5044.11 7 r - 5'2 t..9- /
For multiple products use product approval form
Describe in detail the type of work to be performed: e v i r w 0 , , o o i ( c - i2 z )
Property Owner Information:
Name: A it.r►cy HAmP - Ick Address: 1 /, 3 S&ASPRA /Iv& •
City Arl,A1 AACf•1 State -- Zip 3223 Phone 9.14- 5 .53 - • e222
E -Mail or Fax # (Optional)
•
Contractor Information: 4 J Welk
Company Name: Ftt� -s-r c.a.T P2o t, A-7t: s �, - 3A 5 -'' Ili . *�
Address: P Qualifying Agent: AlL7kurc w� c �S
X13 2 i'I _ -L Avg City . 7144,s4r+ i,7( ss State / Zip 32 1- I I
Office Phone %.l. 53 . a 36 9 Job Site/ Contact Number 4../. 55 tea€ 1' Fax # fly. 3 - 7 y. it i 1
State Certification/Registration # CC C- 1&21i - 1 1
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 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 f 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 Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
Tanks and Air Conditioners, eta
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.
I hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified 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
-'....-4'A. Signature of Contr. tor �:a ". ., r ■■
Print Name L
y ..rYl'1 ri t Print Name O
-(562 •(031- S7.$ g � - f
Sworn to and subscribed before me Sworn to and subscribed before me
thi z• Day rt. b t..r.v,..•1 ,20(1 thi 2 Day of /- , 20
2 4...).:. _
o Public otary Public
yr P% Public State of Florida '' 0l •26.10
S
^ Aura Bouvier :Yv ° u Notary Public State of orida
\ c� My Commission DD892070 Aura Bouvier
ur r �/ Expires 05/21/2013 . My Commission DD892070 Fl
� Expires 05/21/2013
NOTICE OF COMMENCEMENT ' ° am �� O-4 ` ',`y v K b" ' O ` age -19.
umber Pages t
Recorded 02 22 2011 at 02: f 3 PM.
JIM FU".ER CLERK CIRCUIT COURT DUVAL
Permit No, C c UNT '
RECORDING $10 CO
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEME rdance with Section
1.Description of property (legal description): 10- 1 ( C■ 3115 S Au TA et
o Sc`_ C • U 3
a) Street (job) Address:
2.General description of improvements: ti 3 i2. -- A~ A.e& i-1 1 6cq�{ FL 3 z 2 3 3
iv t -, i R '
3.Owner Information Al Ar► c si i-/A,+•t , c l
a) Name and address: yo 3 Sc•A.s P/'- A- A v t r ATLAr 71 c
b) Name and address of fee simple titleholder (if other than owner) p �� r FL 3 2.1.33
c) Interest in property f d. s ,•, w ". ; ,
e Contractor Information . 1r2-5- r - C aA5'F 1'(Lo ?E7t t ,
a) Name and address: 3 y w(C (-kit J c ,7/6, •� /IE }`
b) Telephone No.: 3 2 P� -A�c� .JAcLc /j �� 32 t/
9°`I 553 ov�5 Fax No. (Opt.) 9� 3 /2 r
5. urety Information Y. 7'1. /
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
a) Name and address:
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.)
8.1n addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(6), Florida Statutes:
a) Name and address:
b) Telephone No.:
9.Expiration date of Notice of Commencement (the expiration date is one y a a r from h 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 1, 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. •
Signa , e of Owner o • wner's Au orized Officer/Direc /Partner /Manager
Print Name
The foregoing instrument was acknowledged before me this L - day of b 20 U by
(type of authority, e.g. officer, trustee,
attorney in fact) for (name of party on If of whom instrument was executed).
Personally Known OR Produced Identification ) Notary Signature gnature
Type of Identification Produced 14 544 • 652 • 57- 8 76 Name (print) I ?M rer Boo
OR v
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the for • • -
the facts stated in it are true to the best of my knowledge and belief. _ and that
FORMS/NOC,rvsd2010 F , a�
v Notary Public State of Florida . At
a �' ; Aura Bouvier Signature o atural Person Sig ng (in line # 10.
V) My Commission DD892070
Above
or , Expires 05/21/2013