Permit Roof 2072 George 2011 6 ; .;> tA
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r Zr: ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002108 Date 5/19/11
Property Address 2072 GEORGE ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 19500
Application desc
REROOF
Owner Contractor
NELIGAN CONSTRUCTION (ROOFING)
PO BOX 49249
JAX BEACH FL 32240
(904) 247 -3777
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 150.00 Plan Check Fee .00
Issue Date Valuation . . . . 19500
Expiration Date . . 11/15/11
Other Fees STATE DCA SURCHARGE 2.25
STATE DBPR SURCHARGE 2.25
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 154.50 154.50 .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: __ 0 1 R C c� 5 re\- (�-k- _\ �; _ ?j� Permit Number:
v
Legal Description O 31 ( -- o n e-SS 1?-) P Parcel # 17 d94 - U cos
oor Area of Sq.Ft. Sq.Ft
Valuation of Work $ n,„00. 00 Proposed Work heated/cooled n - 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 Residential
If an existing structure, is a fire sprinkler system insta • r : . e one): Yes No N /A
Florida Product Approval # ti,, 4751 , ci F
For multiple products use product approval form �O�182 .
Describe in detail the type of work to be performed: �� - I VI NA
Property Owner Information:
Name: Q-A Icif\\-kc, 92ye BLit Address: 7 \ (p Oc_pc n R V
M}
City k Pad StateV-t Zip 3aa33 Phone P
�3 -
�
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: N ■c�o.c)Cot`\�\ oc\ au,rti p .\._LC_ Qualifying Agent: t<<cs tit 17, �e_�c . N
Address: O. "1/4 r.- 3,, ..11 City.VicY,�c\ui t \e P,erirt State Ftr,v Zip 3�. - a46
Office Phone i2 9\�, _ l5cA(o Job Site/ Contact Number 1� `,p j1I ; - 7 - 7 °7 Fax # 5 - 1 . j `
State Certification/Registration # ��<<: t -a_r� . .�,
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 aperiod of six 6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Bo 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 I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied w h 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 , te, or local law regulating construction or the performance of construction.
Signature of Ow ner ,.� g Signature of Contractor "2';'/
Print Name , L-•
✓� ! (7 Ci 7 e..v , Print Name
Sworn to and subscribed before me Sworn to and subscribed before me J
this G. Day of Mo,� , 201 \ k this Day of \\v . , 20
E ...,,. NE LAN k■,:. �� t�, , ,: . " . . u ' 14ZA3EIH ANNE - - r ■ LE i
,�,Ii�LI�ta13ETH f31LL ,' l �'
v
No ..... :A.,A _'! iL 41 ,
i'• ..' .'c MY COMMISSION # DD973752 :., ,. • .= J ,
+ - _ MY COMMISSION # DD973 2
sed 01.26.10
- • EXPIRES March 22, 2014 .r ; EXPIRES March 22, 201
0 ow; 398.O — -- Floridalloiary3ervice.com , 3168.04 rl Floricialloisry8ervioemin
NOTICE OF COMMENCEMENT Number Pages: 1 UK ` ` �y Page "''
Recorded 05'05,2011 at 12 3; PM.
JIM FULLER CLERK CIRCUIT COURT vU UAL
Permit No. COUNTY
Tax Folio No RECORDING $10.00
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Secti
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. on
1.Description of property (legal description): 0 3 ,
a) Street (job) Address:
2.General description of improvements: ,�
3.0wner Information
a) Name and address: (2 • (} - . ,
b) Name and address of fee simple titleholder (if other than owner) IL I
c) Interest in property
4.Contractor Information
�}' r a) Name and address: \ L, ' 'UC ¥'.O. <
b) Telephone No (k( c-!) ;�c F >>C 1 " , _k� k= u h �� �I h c�
ax No. (Opt.)
S.Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No.
6.Lender (Opt.)
a) Name and address:
Pne o.
7. Identity of person within the State of Florida designated by owner upon w om not' es 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 ,
713.13(I b Florida Statutes: g person to receive a copy of the Lienor s Notice as provided in Section
a) Name and address:
b) Telephone No.:
Fax 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
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF C MMENCEMENT.
STATE OF FLORIDA
COUNTY OF IIDER ZAIs 10.
Signs er or •. er's Authorized Officer /Director/Partner/Manager
4)/c am-- dr'
y C - C'Ci ,'? O.) >, kec.
Print Name
The foregoing instrument was acknowledged before me this a day of
Y \\ \Cgy , 20 , b
as
(type of authority, e.g. officer, trustee,
attorney in fact) for (name of party on behalf of whom instrumen,( was executed).
Personally Known OR Produced Identification / 1' Notary Signature d4A481100
Type of Identification Produced L c - - -w r \-i \5e. Name (print) L e. \\
l� �l P
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.
FoxMSn10c,rv,d2oi0 $' lik ELIZABETH ANNE LANGILLE
+ MY COMMISSION # DD973732 Signature of Natural Person Signing g gn g (in line # 10.) Above
EXPIRES Mena 22, 2014
I? y Florkt•Noy .Dons