Permit Roof 850 Seminole 2011 Cr r CITY OF ATLANTIC BEACH
� ' $ ) 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
` INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002095 Date 5/20/11
Property Address 850 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning RES SF DISTRICT
Application valuation . . . 29725
Application desc
REROOF
Owner Contractor
CITY OF ATLANTIC BEACH AAA ROOFMASTERS INC
800 SEMINOLE RD 3250 EMERSON ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 639 -8766
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 200.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 29725
Expiration Date . 11/16/11
Other Fees STATE DCA SURCHARGE 3.00
STATE DBPR SURCHARGE 3.00
Fee summary Charged Paid Credited Due
Permit Fee Total 200.00 200.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 6.00 6.00 .00 .00
Grand Total 206.00 206.00 .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
fob Address:
iSZ S/h /i'k1 /c /2,, Permit Number: // 2t /
,egal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Taluation of Work $ 7e' s Proposed Work heated/cooled non - heated/cooled
:lass of Work (circle one): New Addition Alteratioic Re` pair Move Demolition pool/spa window /door
Tse of existing /proposed structure(s) (circle one): Commercia Residential
f an existing structure, is a fire sprinkler system ins ? Cir one): Yes No N /A
'lorida Product Approval #
'or multiple products use product approva orm
)escribe in detail the type of work to be performed: Re ,e610 w /X //D As . ' � a
�
i
'roperty Owner Information: -
fame: / Y ,( 2 M C / 9 F ,16 ` 11 Address: SOU '47 /,//0 7 R4,
ity 4'17.... 7 Stated -Zip 322 - 5=3 Phone 90 2-V 7 — S S'o 1'
-Mail or Fax # (Optional) 7° ( ,q 5z 7 -S )
' ontractor Information:
ompany Name: A / ' Qualifying Agent: �4vAl Er�h /
p
ddress: (J G/ 3 Old JC.'/t) Rd, S. City vX-k State ''L Zip / 7
f .ce Phone 7/ 3 - 7 Go 407 Job Site/ Contact Number lag c405 4 5 Fax #
tate Certification/Registration # cc C 137- SrD 3 C/
rchitect Name & Phone #
agineer's Name & Phone #
se Simple Title Holder Name and Address
onding Company Name and Address
[ortgage Lender Name and Address
Tlication 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
n uance 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
,d 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
Irk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Boilers, Heaters,
inks 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.
ereb 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
v 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
_ , . _ ,00111•"7-1-tili visions of any other federal, state, or local law regulating construction or the performance of construction.
gnature of Owner Signature of Contractor 0
int Name / h/7501/ Print Name M'VIb V /lv
vorn • ,- • _ubsc • ■ - ► before • e Sworn to and subscrd before me
is .i D y If < 20 /( this Day of 20
.....,,,
i . --....-.--- . g
IF
(407) 398-
)tary Public ,.. y M
MY • -
M
*: EXPIRES. a U�gntwc No , i �' • MISSION # EE052841
1: B o nded ThruNa ta ry _. '" EXPIRES Janua i 0 26.10
ff �y, 4153
fi FI•rldeN ry • =. ice, o
IM
n n��'��vl
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 of property (legal description of and address if available : ,
.C- J /
oTS " 7 76 6 /o 3 77) /0 J J* ] j X 4 4F9 GL.L a S� - / 1//2J /-' A a o�
2. General Description of improvements:
//C — 'o OT
3. Owner Information:
a) Name and Address: (� �y
C P /Z 77G t /-} .g.577 5 i n o ( J
b) Interest in property: J e.)77e, --
c) Name and address of simple titleholder (if other than owner):
YDU ,n/ /Z J2 ETA r / / ,t: 32 2 3 3
. Contractor Information:
a) Name and Address: 'Q oF/�71r - 3 Z pm �v d _ -� • i i Fe--- 32 a 7
e17,---b) Phone Number: 9v tiZ 6 3 y - A-76 4
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 (1)(a) 7, Florida Statutes:
a) Name and Address: .JIM /i `U So Ai ° -r- /r2a /� P '49 ,, c 322 3 3
b) Phone Numbers of Designated Person: y0 2 « - 7.n' c' cr
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 AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
,,
ignature .' Owner or Owner's Authorized Officer /Dire ctor/Partner/Manager Signatory's Printed Name & Title /Office
The foregoing instrument was acknowledged before me this 70 da of , 20// , by
din /7 d n as C--e /u ^14 for d1 �TL b7G &,0t c�
(Name of Person) (Authoritf Type, i.e. Offi er/ , ttomey) (Name of P nstrument was Executed for)
w .- ` _ - WHITE �/ i
, rv, DEBORAH A.
= , My COMMISSION # DD s sa�26 NOTARY P LIC STATE OF FLORIDA
;,,. f .. May 2 1, 2 01 1
ters
r k t EXPIRES: Y �nderwd / /1 . //� f 7
Thru Notary Public Print Name: v/ !N °, / 7&--- C)
+r .:: Bonded -
,Personally Known
❑ Identification/Type:
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 know - dge and belief.
Doc # 20111 i 0067, OR 3K i 5604 Page 905, / /
Number Pages: 1 i , /�` '
Recorded 05/18;2011 at 09:40 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL ` t ; afore of Natural Person Signing Above
COUNTY
RECORDING $10.00 Revised 10/1/2009
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
? ( / l Ze 7~
)b Address: \ Ay;) / /„ Permit Number: �"
egal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
aluation of Work $ �',-< `, - Proposed Work heated/cooled non - heated/cooled
,ass of Work (circle one): New Addition Alteratioepair Move Demolition pool/spa window /door
;e of existing /proposed structure(s) (circle one): ( Commercf i Residential
an existing structure, is a fire sprinkler system ins ltalle ? (Circle one): Yes No N /A
orida Product Approval #
►r multiple products use product approval form
.scribe in dethil the type of work to be performed: 7.E' /C°e) 7/
.operty Owner Information:
-, !_ //7//A-' i 1 t / / " *:e � /
Address: tt ' r/
_ - Zi
�, / , ,_ , — , State F_ P ; > > . > Phone - ='.� ` , : ,/ -- C s ,
Mail or Fax # (Optional) , - -/ ,,. ' . ,S" s"
Intractor Information:
P y ,e' e. c-- ; z/r1 J i. 1 Agent:
A
�m an Name: / Qualifying g
[dress: City State Zip
Bee Phone Job Site/ Contact Number Fax #
Gte Certification/Registration #
chitect Name & Phone #
gineer's Name & Phone #
Simple Title Holder Name and Address
nding Company Name and Address
)rtgage Lender Name and Address
)lication 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
lance 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
I void f work is not commenced within six (6) months, or if construction or work is ca nded or abandoned fora eriod of six (6) months at any time after
•k is commenced I understand that separate permits must be secured for Electrical Work; Plumbing, Signs, W ells, Pools, Furnorps, Bo Heaters,
zks 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.
reby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
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
visions of any other federal, state, or local law regulating construction or the performance of construction.
nature of Owner Signature of Contractor T
at Name i l //A/7 SO /7 Print Name
orn , r r *_ ubsc ' • - • before me Sworn to and subscribed before me
;
; ' D yPf ' (' 20 l ( this Day of , 20
Lary Public ,.. '•:r MY a Notary Public
EXPIR Ma y 21, 20
� �C `O Bonded T.11111 Not publk Und•tWr
I + c —
Revised 01.26.10
i V �Mnmt *u.�� ?�
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