The URL can be used to link to this page

Permit Roof 416 Sargo 2011 j 1 -j -\ -IV ,P ti f - CITY OF ATLANTIC BEACH ;, 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 P.: - / -. 0 1119'' Application Number 11- 00001836 Date 3/25/11 Property Address 416 SARGO RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 5100 Application desc reroof Owner Contractor HAMIL ACACIA ROOFING COMPANY INC 416 SARGO ROAD PO BOX 1777 ATLANTIC BEACH FL 32233 ORANGE PARK FL 32067 (904) 298 -2170 Permit ROOF PERMIT Additional desc . Permit Fee . . . 80.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 5100 Expiration Date . 9/21/11 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. NOTICE OF COMMENCEMENT Permit No. Tax Folio No. State of Florida, County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description ofpro,per (legal description of property and address if available): i b ! )' A F'tccT cf Po --t - c gcyra I ectio. ,,n l t . 9, t 4 2. General Description of improvements,,;. A w: -ter j' / /'`: :.,.,_ 3. Owner Information: ., +cam y �l , a) Name and Address: tz�J1 f a .0.. /f(,..�> () c.r °r'. . C/, / A. ,--7- ;L,- .t. 'Ca, r4,1 ; '1 3 i :' b) Interest in property: C\,- (art . ' c) Name and address of simple titleholder (if other than owner): s d ,�r 4. Contractor Information: a Name and Address: . ar°,aC " rY'1��tPyr�_ i ") ... .,11 ... St �fi� ?t[ f�(- 1 J <V -� )L, 1( . 1 7 -. ! ` ti i ` i b) Phone Number: C p tj_ ; - G / ` . y J r , .) / 5. Surety Information: a) Name and Address: b) Phone Number: c) Amount of Bond: $ 6. Lender Information: a) Name and Address: b) Phone Number: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13 (I)(a) 7, Florida Statutes: a) Name and Address: b) Phone Numbers of Designated Person: . • 8. In addition to himself /herself, Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. a) Name and Address: b) Phone Number of person or entity designated by owner: 9 Expiration date of Notice of Commencement (The expiration date is one (1) 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 WITH YOUR LENDER OR A ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE C ENC1MEN , Signature o Owner or Owner's Authorized Officer /Director/Partner/Manager Signatory's Printed Name & Title/Office • _ The foregoing instrument was acknowledged before me this day of , 20 , by as for . (Name of Person) (Authority Type, i.e. Officer /Attorney) (Name of Party Instrument was Executed for) . !� • i t.A . CHRIS CAMP m NOTARY PUBLIC STATE O �_ C omm i ss i o n # DD F FLORIDA n' Ex 9=#4694 p 0:0 ` Expires Decent r , 2013 Print Name: t B on d ed i r Troy ran m�,r �,,es•raie Fl Personally Known tJ Identification/Type: Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 1 declare that I have read the - foregoing and that the facts stated in it are true to the best of my knowledge and belief. uoc ZUI iun'blO, UK tSK 1555L r age �li Number Pages: 1 Signature of Natural Person Signing Above Recorded 03'24.201 1 at 03:56 PM. JIM PULLER CLERK CIRCUIT COURT DUVAL COUNTY Revised 10/1/2009 RECORDING $10.00 , CITY OF ATLANTIC BEACH 07 I I I I I .. ,:_. �;<, 8 00 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 J it OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 BUILDING- DEPT@COAB. US ??-'/ BUILDING PERMIT APPLICATION DUVAL COUNTY 1. JOB. ADDRESS: 2. VALUATION OF WORK 3. SQ. FT. UNDER ROOF 9« OA 4O Atlantic Beach, FL 32233 $/00 1700 4. LEGAL DESCRIP ON: 5. CLASS OF WORK 6. USE OF STRUCTURE: n A y d ❑ NEW BUILDING ❑ DEMOLITION MI RESIDENTIAL LOT 14 BLOCK It SUB DIVISION IZOyat�J Pa (44. a ❑ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL 7. DESCRIPTION OF WORK ❑ ALTERATION ❑ ACCESSORY BLDG. 8. FIRE SPRINKLER: J ``JJ ❑ REPAIR 0 POOL / SPA ❑ YES IIg.N /A R �Q,!`1©ti / (/ ❑ MOVE ❑ OTHER ❑ NO PROP RTY OWNER: CONTRACTOR: ARCHITECT / ENGINEER: 9. NAME: 8 14 ,, I 15. COMPANY NAME: 23. COMPANY NAME: 16. NAME: Raj ' l (Dhallp.1y I � 24. LICENSEE NAME: ' n G,a -r2.a- 10. ADDRESS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.: 41 (4 / 5°4" ed cCc /;24119z. �� R 32133 18. A DDRESS: C � I Z 26. ADDRESS: - Sac es i vi Ile- FL 3225'7 11. OFFICE PHONE: 12. FAX NO.: 19. OFFICE � PHO 2 NE 20. 13- NO.: q� 27. OFFICE PHONE: 28. FAX NO.: 11 CELL PHONE: 21. CELL PHONE: 29. CELL PHONE: (03 i (15' 110-5'4Iii© 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: IC Ct4 @ A cs c a lie A • c. ,..-, FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: OF OTHER THAN OWNER) 31. NAME: 33. NAME: 35. NAME: 32. ADDRESS: 34. ADDRESS: 36. 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 Electrical Work, Plumbing, Wells, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. 222 WARNING TO OWNER: 222 YOUR FAILURE TO RECORD A 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER or AGENT CONTRACTOR As (If, , ent Power -• ey Ji • - / // , Letter Required) r (Qualifier Only) Signed: /� �� /�� IITi , / Date:3 -ail - / 1 Si , .., D ate: G " f`k � l • Before me this da . ... • .f Befo _ �r , 2007 in the county of �,_, • ^ POS t 11f_ e). pp Duval, State of Florida, has e d T' o l i �n) i ss i on # DD °44694 Duva � !� %.,:l. n ` c rti . Li 1 , - �. <<c Ex December t, 21)13 , a s ,t Lxi;jrt 11« r,ftu t , )s';, ;, herin by himself / herself an. ' w rica aih - herin ' -I 'herSSF1'=afld affinfl9+11af3tatio t teiii s and declarations are true and accurate. true and accurate. Notary Public at Large, State of , County of Notary Public at Large, State of , County of j Personally Known ❑ Personally Known droduced Identification - Produced Identification - Notary Signature: .-- - "'°"=- "' Notary Signature: COAB FORM BLDG01: REVISED: 10/26/2007