Permit Roof 2361 W Oceanwalk 2011 i'j L .Al r
r �L CITY OF ATLANTIC BEACH
z
-,, 800 SEMINOLE ROAD
'- e ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
i *Ji3 s),:?,,,
Application Number 11- 00002119 Date 5/20/11
Property Address 2361 W OCEANWALK DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 11196
Application desc
REROOF
Owner Contractor
DELUNA /HOSS K & D ROOFING & CONSTRUCTION
2361 OCEANWALK DR.W. 2758 DAWN RD SUITE 1NE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 553 -1381
Permit ROOF PERMIT
Additional desc .
Permit Fee • • • • 110.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 11196
Expiration Date . . 11/16/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 110.00 110.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 114.00 114.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
' ;(1TICE OF COMMENCEMENT
State of Florida. County of fl ' -ni
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance v. in
Chanter 713. Florida Statutes, the following information is provided in this Notice of Commencemcra.
1. Description of property (legal description ofpr c etI n t a W d R ( if art p r . i 1
ff. O F. /
J
3. owner information: r
.,."._ .:n� scorns: __ J I , e t. 3 / ? " C � Le op C,,, ( 1 , � ,t J i
b) Interest in property:
c) Name and address of simple titleholder (if other tnan owner]:
4. Contractor Information:
a) Name and :taoress: 1.{ E 1b _ 1 0 it1( ,x Dom it Rd,.. , . 5i 1 JC;rX , - 1 .:) -�(-' 7
b) Phone Number: Sit, - - `j'-ii i t C
IA/ 5. Suret Information:
e
\ddress:
b) Phone Number:
c) Amount of Bond: S
6. Lender Information:
a) Name and Address:
b) Phone Number_
7. Person within the State of Florida designated by owner upon whom notices or ether docutnens may be ser: ea as
provided by 713.13 (1)(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.I3 (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 OW IER: 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 'i'WICE 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.
signature o ' ner or Owner's Authorized 0 reer /Director.PartnerManager Signll!ory's Printed Name & Title /Office
The foregoing instrument was acknowledged before me this K
ru day of /t- ACA-7 , 20 , by
/3 - O< �(j n--& as G l<.' s for
i ` me of Person) (Authority T yre. i .e. OfficerrAnomey) (Name of Party Instrument was Executed for)
L. . -. _- - _ -.
n, JK �sK t5 ni)i ra ge 23 12"
Number Gages: 1 NOTARY PUBLIC. S F1
Recorded 05;20.2011 at 03:04 PM, Print Name: / s
! 7 C Q
JIM FULLER CLERK CiRCUiT COURT DUVAL
COUNTY •-'ersonally Known
RECORDING S10 00 : Identification /Type:
Verification pursuant to ..,t.,,..,.. - -•- - , 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.
Signature of Natural Person Signing Above
'.' MIL ROBERT HILE
Commission # DD 889710 Revised 10/1/2009
T' Expires March 11, 2013
V. 5162
t.
l' CJr 10 -
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date: S `3 - • 2 //
Job Address: 2 J6 l 0 C e q q (A ) cf/4 T
Owner of Property: ISse_42 i of ,Vl : 1 `Fit. n L �__
Address: a jo / (')a e z h (,r)Ctl r k),--
' C Telephone:
Roof Contractor: /2 ( ° .r // t it- State License Number: C C C / 3 258 •S,2
v `<i —J� �1 ?
Contractor's Address: �� �I L.° J k Jc^ J
nn l c�
Telephone: 7v � �-. S �/' "7T7: Email: ,� g' .,� �a�� �� & ��rn Z•, F /z..
Scope of Work: A rr.rU/7 S d.- )c 7- S), /A-5 Abofing Material 5 Al 4 ,
FL Product Approval # i" /6 / 2 , / 67 Valuation of Work: S / / / /7 t'
Required Inspections: Sheathing /In Progress -Dry In / Final
If re -roof: Assessed Value of Structure: _ < $300,000/ >$300,000; Roof -to -wall improvements required?
( Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
SIGNATURE OF OWNER' �^ . �` / Date: .7 —.3 .' 2.0/ /
AS TO OWNER: �� f
Sworn to and subscribed before me this 3 day of i y , 20 C. ( .
State of Florida, County of Duval I
Notary's Signature:
'' '� ROBERT RILE personally known
u ,.,b ,, Commission # DD : .,!710 ❑ roduced identification
,,.,* Alt r
jj Expires March 11, 2013 Type of identification produced
WIMI/ iNYT einki,_ . //
, ^7�YILwr i � 1,- % , �� � , r- ' ���
SIGNATURE OF CONTRACT • ' : ' .►.� /. _ . Date:
AS TO CONTRACTOR:
Sworn to and subscribed before me this 2'0 �y� day of l i ) 01 , 20
State of Florida, County of Duval -
Notary's Signature: t!1
ersonally known
Produced identification �-
DONNA M BOLEN Type of identification produced t� 1(„A- t 0 A D L
•: ' - MY COMMISSION # EE0521
-.4 • ' EXPIRES December 29, 2014 800 Seminole Road • Atlantic Beach, Florida 32233 -5445
n, Flo�WI$ senoce.com Telephone: (904) 247 -5800 • Fax: (904) 247 -5845
(407) 3 980153 F: \roof permit applicaton 2010