Permit Roof 1160 W linkside Ct 2011 «$ j t Jf
ti p' '� ` CITY OF ATLANTIC BEACH
5 'f 800 SEMINOLE ROAD
" ~ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
' C),Ftl9
Application Number . . . . . 11- 00001697 Date 2/18/11
Property Address 1160 W LINKSIDE CT
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 7400
Application desc
REROOF 183.9
Owner Contractor
THOMPSON LINDA BOHEMIA CO, INC (ROOFING)
1160 LINKSIDE CT W 3950 ST ISABEL DR E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32277
(904) 859 -3539
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 90.00 Plan Check Fee .00
Issue Date Valuation 7400
Expiration Date . . 8/17/11
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 �y
Job Address: 1160 LINKSIDE CT W, ATLANTIC BEACH, FL 32233 / / // v�
Permit Number: / (p
Legal Description 44 -93 17- 9S -99F 3F1 VA I INKsinE t NIT Parc$4037 S 10
Valuation of Work $ �Q Floor Area of Sq.ft. Sq
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 structure(s) (circle one): Commercial idential`
If an existin g structure, is a fire sprinkler system installed? (Circle one): s o N /A
Florida Product Approval # L 2 , • q /gi 291 ( Met K J a ',/ s
p
For multiple products use roduct approval form
Describe in detail the type of work to be performed: COMPLETE RE -ROOF, REPLACEMENT WITH SHINGLE
Property Owner Information:
Name: 11 e IA 'E f Addres
A i )� 1 I
City ��.� ri1'i '� State r(p -one / 6,� n KC I A P C-1-,
E -Mail or ax # (Optional) (404- a7 y �S'
Contractor Information:
Company Name: BOHEMIA ROOFING CO., INC. IVANA HODULOVA
Address: 3950 ST ISABEL DR E Qualifying Agent:
City JACKSONVILLE State FL
Office Phone 904- 859 -3539 Job Site/ Contact Number 904- 982 -2114 Fax # 904- 353 -2700 Z'P 32277
State Certification/Registration # ccc1328464
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. / certib, 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. 1 understand that .separate permits must he secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, 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
i ff i ,
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTI OF
e,�51GN COMMENCEMENT.
ptEA. ►,FYIf
8,NO� / hereby certify that / have read and examined this application and know the same to he true and correct. All provisions of laws an o. / n ices governing this
Rf type o work will he complied with whether specified herein or not. The granting of a permit does not presume to give autho ity i'' iolate or cancel the
provisions of any other federal, sh e, or local law reg lat! g construction or the performance cif
Signature of Owner A , f
/ . I M 44 Signature of Contractor -4411 -4411 Print Name ..t.! (/l,{ omp,soci ..............._J O 1 UD u-
Print Name '�, �- . / v /� ��k"'
........ ...............................
l�
.... ........ ........... ...... .....
Sworn o and subscritgil before me Sworn and subscrib
this l ay of a rk , 20 I I this I o e me Day of 20 i/
Notary ub ic
'
Notary Public P'A �
"-Notary Public, ttate of Flofidi
> , ..:.;;i'. " :ti 4•- ENID V. JOHNSON My Comm. exp. d 4�'
• ` #� 4 Commission mmission DD 797850 C • DO 711 6
;,,: a Expires June 15, 2012
• .,,,v,70,.• Bonded Thru Troy Fein Insurance 800.385 -7019
PAV €L R a iy
Notary Publi r . f F ida
My COMM I _ • 11
Comp. • r0 1 306
/
NOTICE OF COMMENCEMENT •u _cc r ` �" I �� aye , i0 , 0
E° �aC S n '
'9CCfCec ,` ,3 2211
I __c? OLERi< C RC:,f CCuF2 — DUV> ,
Permit No. = ",'v
Tax Folio No. = RC^ S' CO
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.Description of property (legal description): 44-23 17- 2S -29E SELVA LINKSIDE UNIT 01 LOT 41
a) Street (job) Address: 1160 W LINKSIDE CT, ATLANTIC BEACH, FL 32233
2.General description of improvements: COMPLETE RE -ROOF, REPLACEMENT WITH SHINGLE
3.0wner Information
a) Name and address: _ j J I ` • C-+ J
b) Name and address of fee simple titleholder (if othe than owner) — I !b �C�
c) Interest in property OWNER I
^ .Contractor Information
3 22
f t, a) Name and address: BOHEMIA ROOFING CO., INC. 3950 ST. ISABEL DR E, JACKSONVILLE, FL 32277
b) Telephone No.: 904 -859 -3539
5.Surety Information Fax No. (Opt.) 904- 353 -2700
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
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.:
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 n
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 ~
Signa u of Owner or Owner's Authorized • ffcer/Director /Partner /Manager
Print Name
The foregoing instrument was acknowledged before me this v 1 day of 1
134 rrl espn as
(type of authority, e.g. officer, trustee,
attorney in fact) for
(name of party . • ehalf of wh • instru
� 11
1 • l 'x+Mtie�JOHNSON
Personally Known OR Produced Identification ./ ' � ,■ TA Commission DO 79785
Notary Signature _ ! .' *� t��,:
� ■�,: Expires June 15, 2012
IL. ■
Type of Identification Produced Name (print) t d v .� a 1 A ' . "
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 it are true to the best of my knowledge and belief. -. �
FORMSMOC.n sd2010
Signat o Natural Person Signing (in line # ,.) Above
Isar