Permit Roof 795 Plaza 2011 N ''I CITY OF ATLANTIC BEACH
. w�' mk � 800 SEMINOLE ROAD
J " °'" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002008 Date 4/28/11
Property Address 795 PLAZA
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4450
Application desc
reroof
Owner Contractor
CORNER LOT PROPERTIRES RON RUSSELL ROOFING INC
4419 HUDNALL RD
TEMPLE TERRACE FL 33617 JACKSONVILLE FL 32207
(904) 636 -9909
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 4450
Expiration Date . 10/25/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. '
State of rLd R( cm. County of 'p (//k -�
To whom it may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property, and in
accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT. n1 (�
Legal description of property bean i roved: 30 - O b O 3 8 - Z S - Z -1
Address of property being improved: 79 S pc..t t A S 4. ft T _ .14 /Tf C B eoico,FL .
3 2.2.3 3
General description of improvements: 2'.e. Roe F
Owner IS- ter T'/t to J� T�1�5 [EGG►
Address 79S ILA 3T , A rGiNr<C 13E14C14 / FL. 3 2 :3 3
Owner's interest in site of the improvement f9 w /() e
Fee Simple Titleholder (if other than owner) .Si* nri . A-S 9180 1J E
Name
i Address
0 �, .� Contractor /�on1 IZ0SS ROOF%NU Lk ,
�� Address . 41% 1 -9 -- f4.IJD.NAGC..- RO#b <SOl l i/%GLE PL._ 3 2207
�� Phone No(904) ZOO " /// Fax No. (p 3 6 "' 990 Q
Surety (if any) A '
Address N Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address / ///
Phone No. Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name Ron) RU SS EGC.. ROOF /NCr) Z,1/C.
Address +41-19 /fv bn/Ae.` ROArb TA-CfkSoNCliu_E F. 32207
Phone No. (Q04) ZOO • / (/ a Fax No. (YOO) Co - / qo 9
In addition to himself• owner designates the following person to receive a copy of the Lienor s Notice as provided in
Section 713.06 (2) (b). Florida Statutes. (Fill in at Owner's option).
Name Al/ft
Address
Phone No. Fax No.
Expiration date of Notice of Com encem nt (the expiration date is one (1) year from the date of recording unless a
different date is specified): 4, - Z. / /
THIS SPACE FOR RECORDER'S USE ONLY
q ; Signed: DATE , G d ' Before me th Xki......?........./..ymiNER
ay of prt2.1.1 , I in the
County of D al. St of Flo Jde. has personallyy appeared
L, r c. S SY. C . , Z L. herein by
himsNU h U and affirms that all -
Doc iF 0110v4f3r, OHS t3K iBo8b Page 1 B / 3 , are true and accurate I
Number Pages 1 " • ' ERICA A. WOOTEN ¢ 4
Recor 04;13 2011 at 01:25 PM, i + ! t`° MY COMMISSION # EE 60963
JIM FULLER CLERK CIRCUIT COURT DUVAL
a 1
COUNTY .. Sa „,:,. EXPIRES: February 2, 2015 •
RECORDING $10.00 Notary Public at Large, State of .' T_ — '
My commission expires: 1~e' t- . 7 i e 1 I7a
Personalty Known or
Produced Identification C t--- L) L
E, - a L- -t ' " %L.-
.BUILDING PERNIIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: '214 f , ;'7 .AN TeC.:.
F Permit Number:
Legal Description 3 "0( 3$ -Z - ate "gym, rag,2 tharriparcel #
Valuation of Work $ '4 .
Class of Work (circle one): New Addition tera Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): ercia[ �esiden a
f an existing structure, is a fire sprinkler stem installed? (Circle one): `Y es ico
?lorida Product Approval # f L 1¶ SO ' i
For multiple products use product approval form
` 4 79. 1 3 T�tef/
describe in detail the type of work to be performed: ite pow Z S YR �g� 1 o „ � rYl
Moro Cr I rn BACK 70
'roperty Owner Information:
Tame. Address: 7 ?5"" PLA'EA ST
/ T7i:. se-o4 -C{ / State Ft. Zip 3 Z23 3Phone ( 4o4) 3 o 3 *4-4E5
3 -Mail or Fax # (Optional) ( Yoh.) o 78
"ontractor Information;
ompany Name: P-ON) RAYS SeL.L..['tt•F►'NCs ZNe, Qualifying Agent: (ZanJ fi u&
cddress: 4419 NOD N AL.L. I D , City .7'r4CfCtt24)1/41ti t LL 6 State F L Zip 3 Z td 7
)ffice Phone(gp 40 (0 36 - o' Job Site / Contact Number 964 200-i (f $ Fax # 10 b .
tate Certifica on/Registration # C CC. 1 327 4 $�(- 3 4q 9
Lrchitect Name & Phone # N
ngineer's Name & Phone #
ee Simple Title Holder Name and Address K, y 64. / Aski✓e 0.0rz
onding Company Name and Address
fortgage Lender Name and Address /
oplication is hereby made to obtain a permit to do the work and installations as indicated I certif that no work or installation has commenced prior to the
suance 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
7.d void f work is not commenced within six (6) months, or if construction or work is suspended or abandoned fora eriod of six 16) months at any time after
ork is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, tells, Pools, Furnaces, Bo Heaters,
inks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMIVIENCEMENT 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.
iereb certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
Ye 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
ovisions of any other federal, state, or local law regulating construction or the performance of construct
gnature of Owner 21k."?' Signature of Contractor c)..
,> � ctor
int Name kyle PA.S3 W
Print Name f t(.,z) e c,
vorn to and subscribed before me Swo to and subscribed before me
is Day of (�rt ( , 20 11 this Day of - .r r Y Vi , 20 1)
Akca,
?t I [� <�'lAlt (
ary P lic
Notary Public
N. ERICA A. WOOTEN 0
MY COMMISSION # EE 60963 I ' . WOO
'"'- 1 _ MY COMMISS # EE TEN 60963
r EXPIRES: February 2, 2015 ""
'a. ho% %,, ,���� EXPIRES: February 2, 2015