Permit Siding 1907 N Sherry 2011 Js CITY OF ATLANTIC BEACH
V -' 800 SEMINOLE ROAD
..- ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
4011
Application Number . . . . . 11- 00001786 Date 3/15/11
Property Address 1907 N SHERRY DR
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 8330
Application desc
SIDING
Owner Contractor
GABRYNOWICZ SIDING INDUSTRIES OF
1907 N. SHERRY DRIVE P 0 BOX 840292
ATLANTIC BEACH FL 32233 201 BASQUE ROAD
ST.AUGUSTINE FL 32080
(904) 460 -9367
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 95.00 Plan Check Fee . . 47.50
Issue Date . . . Valuation . . . . 8330
Expiration Date . 9/11/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total 47.50 47.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 146.50 146.50 .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: 1 96 7 *:5 4 t e re l d R Permit Number: _
` Iv,i 141.41-,A)04- Legal Description 3 7 - Lk) 9 i 9 — ,PS - a '7
Parcel # I2_0 Z ^ c�81
A re
Floor Are of Sq.Ft. Sq.Ft
Valuation of Work $ 8 `3 30 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 structures (circle one): installed? Residential ' \
If an existing structure, is a fire spnnkler system nstalled? (Circle o N /A
Florida Product Approval # ) ?, ( cl Z 2—
For multiple products use product approval form
Describe in detail the type of work to be performed: 5 T ps I 1 0-‘,.. 4- di L L A p Sid, t' '
Property Owner Information:
Name: Iry ca ('K a Psb r '. / IA a 1L l c 2._ Address: 190 C 7 V. S'L e f (�( b (Z.._
City pfil r t C (3 e A i State l =(,Zip 3 223 Phone _
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: _c (ct +u �1 i _Lod LS T Qualifying Agent: a tA°`-' V' I (P k er
Address: po (36 K. y 0 2 5 2_ City Cr_ ..'i . State / Zip 326 SO
Office Phone L-(60 3 4e 7 Job Site/ Contact Number f3i Y 7 9 Z3 Fax # B / s'- fo 7 .7
State Certification/Registration # C /2 C 13 Z 7 9 3 Y
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_period of six (6) months at any time after •
work is commenced. I understand that separate permits must be secured for Electr 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 YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
I hereby certify that 1 have read and examined thisplication 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, st ate, state, or local law regulating construction or the performance of construction.
1 / .
Signature of Owner r 1 II � v \\ �/
���/// .ia " ` . JOHN KELLEHER
Print Name ^ i l,\ A4 IL I '' - ' , /?- 1 ' ' 4+1 - MY COMMISSION a DD650666
%, ' ' EXPIRES: March 14, 20 _ _ _ _ _ _ _ _ _
JOHN KELLEHER
Sworn to and subscribed before me I -MO- NOTARY FI. Notary Discount As • o. 00 N,,
this o2 Day of ,)jsfrck , 20 1 - 04 Notary Public • State of Florida
• • • e My Comm. Expires Mar 14, 2015
4, ANY-." 1: 4. .j o, Commission ii EE 69452
°' € °,'t o p Bonded Through National Notary Assn.
_oc a 6v, age io
NOTICE OF COMMENCEMENT uc 'ages
Recoraea ,:3 15 01' at C8 45 ANL
4,t
=_L_ ER CL =:Rk. 0 Cu'T COURT DUV,ai_
Permit No.
E 0 R'D:NG S''J CO
Tax Folio No.
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 : X3 - Li c' S Z5 C � � ( ,, 'if t 1' f rF , r , - r;
a) Street (job) Address: 1 'c:.` 7 A/ <_./^ S� e ! �'Y Z fl`7/,- 7 i, - .fc c, Z 3 22 3
2.General description of improvements:
3.Owner Information �� `, z , , , r , , -
a) Name and address: Is4 rte K vk y l C IO 7 0't' S y Az r477P64-7;C
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property I r.- , cI . • • c---
4.Contractor Information 1
a) Name and address: .2 , v X yC 2 2c e
:4)\ )k\cf , !‘ rey b) Telephone No.: l , 4 7 5 2. 3 Fax No. (Opt.)
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(1Xb), 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 FLO' ! , h A n
COUNTY Of P t LJ 'N, JOHN KELLEHER 10. :' v . '
ii
MY COMMISSION a DD650666 Signature of& oer or 0 er's uth. �'� • I /Director/Partner /Manager
? T EXPIRES: March 14, 2011 r'�^/i ( " ' f W� 7 ----
1.8443•NOTARY FI. Notary Discount Assoc. Co. Print Name
The foregoing instrument was acknowledged before me this day of 1 ("<- ( , 20 1 t , by
as (type of authority, e.g. officer, trustee,
attorney in fact) for Y\ vk " << G &b r'' t.. t (.z- (name of party on be of whom in -trument was executed).
Personally Known OR Produced Identification Notary Signature
Type of Identification Produced l — L X 11 — Name (print) J 6 (��--
lee LI e h C --
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, l declare that I have read the foregoing and that
the facts stated • • belief. r-
,,w�nu,,, JOHN KELLEHER (�
Pitt ; Notary Public -State of Florida � � ..
FORMS/NOC.rvsd2ot0 , ,, „._..
My Comm. Expires Mat 14, 2015 Signature ofN P n Si • g (in l'`0.) Above
N. ' Commission # EE 69452 �� \ (
1 % % ° ; p, ,, Bonded Through National Notary Assn. - \
Iry
-.411111V-■ -
Signature of Contractor
PPP"
I -
Print Name A eke r"
Swo 20 ' .ubsc . 4 / 0
this ot of
pFEwy„,
„
No ",- '
- ised 01.26.10
. SHIRLEY L GRAHAM
Mv COMMISSION * DD 957760
EXPIRES: February 14, 2014
Bonded Are Notary Public UndelvottetS