Permit Roof 999 Hibiscus 2011 S tom' I.
dr
, CITY OF ATLANTIC BEACH
; f 800 SEMINOLE ROAD
J « > ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002170 Date 6/03/11
Property Address 999 HIBISCUS ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 6125
Application desc
reroof
Owner Contractor
PORCELLI TOWNSEND ROOFING &
999 HIBISCUS STREET CONSTRUCTION SERVICES
ATLANTIC BEACH FL 32233 2771 -29 MONUMENT RD #338
JACKSONVILLE FL 32225
(904) 645 -0796
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 85.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 6125
Expiration Date . 11/30/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 85.00 85.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 89.00 89.00 .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. ) (61 ( A — 0 4 006
State of Fir:,-a% County of VkJAt
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.
Legal description of property being improved: 1 S - 3 y �� 15 Z c . H
f4'-1`kA +■ eeact Lt,- 1,N )/2 Lot- Z t 1k 1 57
Address of property being improved: ° VA l H; ; 5 CL&- Str
- (A„, f c_ e d„. , FL 3 ZZ3 3
General description of improvements: c v eT (4 -r to C.e_fMer^'f
Owner f cr C ki r (1 (-1--"("
Address 12 1, 2... Pt.S A- lArx, k L P ' ( NO pc 3 2 efeyz
r
Owner's interest in site of the improvement ow iJ _
Fee Simple Titleholder (if other than owner) i t.i AvI Ai ii-1.
Name
A Address
Contractor To
wnsend Roofing and Construction Services, Inc.
. 11) / Address 10418 New Berlin Rd #115 Jacksonville. FL 32226
Phone Nc:. (904)645 -5887 Fax No. (904)645 -5442
Surety (if any)
Address Amount of bond S
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
Address
Phone No Fax No.
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
Address
Phone No, Fax No
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a t
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY r i O R
( .
Signed- D 1 �Za { 1
Before me this day of �. �q r i ".s - :n the
Coumy of puval Sta o` 7 u:oda, has p a
ti raon�7y�
r o n..o l t; heroin by
himself/ - Mall saatesianta agif deicer4o %hem in
are true and : , rats„ , , ,
?�� "� CHRIS TOWNSEND
Doc rr 201 1 23029, OR SK 1 5619 Page 543, : 1 :. _ Notary Public • State of Florida
Number Pages: 1 :t j�� A d My Comm. Expires Mar 25, 2014
Recorded 06/03.'2011 at 02:20 PM. Notary Publ c : Larcre; ?' tt? • y +'r :'
JIM FULLER CLERK CIRCUIT COURT DUVAL My comm.' - • .'
COUNTY Personarly Known or
RECORDING $ 10.00 Produced idendflcatton
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: l ( 1 1 R c\ t S 0 45 51 Pernikit Number:
9 �� I N�,z Lu+ 2- ( K- 15 7
Legal Description
18 3 9 1 "1-Z5 - Z E q f • feu / Parcel # ) 78 9 `f i - 6660
/ o c: Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $
/ 1 Proposed Work heated/cooled non - 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 sitiEnti D'^? 1
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes A N N /A
Florida Product Approval # 1 115 , g5
For multiple products use product approval form ' n fp
Describe in detail the type of work to be performed: a 0k� tq�
- arc c c 5k - ,,i,5 f 0 F ft ( ?..e r rL12, `17
Property Owner Information:
Name: ( k% ( P,, (`C - �
l 't �� s r Address: 1 61 is Hd 0k t"la y
City ?U(, Stater!. -Zip 32-08 Phone `l0`1- 2`i `f" I`t32-
E -Mail or Fax # (Optional)
Contractor Information: ` ,p -�- /
Company Name: 1�1. 5t ( a ` r � 4- '` ?`r �s, �' Qualifying Agent: h i "d y (off �'
to"
Address: 1 ?918 Nu...) 13er(;,, Rd N-5 City 3 Ax State FL Zip 3 Z 1Z-4
Office Phone I OH- 6 `f s 5%27 Job Site/ Contact Number 9/ 2- - ` `t -7 9 Fax # 69 5 -5 `t y Z.
State Certification/Registration # L - f 32:A2_89
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. 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Boilers, 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.
1 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisio • laws and ordinances governing this
type of work will be complied with whether ci red herein or not. The granting of a permit does not presume ' authority to violate or ca • he
provisions of any other fe ral, st e, or ocal aw gu ng construction or the performance of construction. A
Signature of Owner ( Signature of C. r • t
Print Name 1 A� - 1
- o u 4 V - Ll - Print Name t o is ns rd
Sworn to and subscribed before me Sw, rn o and subscribed before me
this Z' Day of JiA /fit , 20 (1 tit'. D Day ,A L .1 20 I 1 II 4
l/ - - - - - - - ., '. ?
`;P � e'' 1 Notary ' i, i '? - c � . ' ; ULUNGER
Notary Public ■ i. n. c CHRIS TOWNSF N(J • Notary Public - State of Florida I _
" Notary Public - State of Florida OA''
i �, iii . - • My Comm Expires Mar 25, 2014 % ' 1 My Commi2Expir:e4 th t9, ¢ol , aq'
�� � `- - - Commission # OD 974821 � �� %.'ti td . Commission 0 DO 974849
�' 1, .' �o ��;:�
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