Permit Roof 501 Clippership 2011 , � . , �s CITY OF ATLANTIC BEACH
-; , 800 SEMINOLE ROAD
k
- N ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002224 Date 6/16/11
Property Address 501 CLIPPERSHIP LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5800
Application desc
REROOF
Owner Contractor
KOPP STUDARD ROOFING
501 CLIPPERSHIP LANE 423 LAKE MARIETTA DR. WEST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32220
(904) 786 -9573
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 80.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5800
Expiration Date . 12/13/11
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 80.00 80.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 84.00 84.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 S= IJINOLE ROM, ATLAV'IC BEACH. FL 32233 07-
Tf V ry 11 _. �_
f.' OFFICE: (9C4)247-5826 • FAX NO.:(904)247 -5845
BUILDING-DEPT @COAB.US
_ BUILDING PERMIT APPLICATION DUVAL COUNTY
1..108 ADDRESS :, . , . 2. VALUATION OF WORK: 3. SQ. FT. UNDER ROOF
Ste / c.i./ 1 /t (4/1,7 LA(' 5e . ® -
4. LEGAL DESCRIPTION 5. CLASS OF WORK: . - ..... _ ... 6. USE OF STRUCTURE:
0 NEW Butch* 0 DEMOLITION 0 RESIDENTIAL
LOT BLOCK _ SUB DIVISION 0 ADOrrioH 0 CONVERTING USE 0 COVMAERCAL
7. DESCRIPTION OF WORK: • • 0 ALTERATION 0 ACCESSORY BLDG. a. FIRE SPRINKLER: -
•
0 REPAIR 0 POOL 1 SPA 0 YES 0 NIA
/ 4� `'Q 0 0 OTHER 0 wo
PROPERTY OWNER: .. . CONTRACTOR . . ARCHtt"ECT ENGINEER:
9. NAME: 15. 0 AXI.7 23- COMPANY NAME:
16. N E: / 24. UCENSEE P1AME:
10. ADDRESS: 17. STATE OF FLORIDA UCENSE ND.: 25. STATE OF FLORIDA LICENSE NO.:
s• 0 r C.G. / f'PC-D2 S i4 t/' LA(
_ d 7 Tfo
18. ADDRESS: 26. ADDRESS:
qa..3 LK . cur. ,
oir •-. - -.....14 11
, 11. OFF!CE PHONE: 112. FAX NO.: 19.9FF_ICE PH 5.-.V 0 0 .� r 27_ OFFICE PHONE: ' 28. FAX NO.:
13. CELL PHONE: 21.. CELL PHONE: J 29. CELL PHONE:
to 5 - 5 --- 6, O 7
14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: '
FEE t . SIMPLE LE i ONDlNG CO_ iMPANY:. . . ..- .. MORTGAGE LENDER:
31. NAME: �+�. 33. NAME: 35. NAME: _' 1--...
32. ADDRESS: 34. ADDRESS: 36. 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. I understand that separate pennits must be secured for
Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bolters, Heaters, Tanks, Air Conditioners, eta
OWNER'S AFFIDAVIT - t certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by taw.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A 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.
. • OWNER Or AGENT.: -- .. ' . .... CONTRACTOR . .
• . -_ (I Agent. Power RAtidmey drAgency Latter Requavui � �
, . :..
Signed: /,.
Date: 69 1/6/1/ Signed. c...__ _ - Date: (
Before me this day of . 2007Inlhe county of Before me this ' day of ++ . , 2007 in the county of
Duval, State of Florida. has personally appeared Duval. State of Florida. has personally appeared
:lertn by himself t herself and aflkms that all statements an • dec!ara5ons are herin by himself 1 herself and affirms that all statements and declarations are
true and accurate. / /� / true and accurate. / j
Nola cat : rge, r '- • rrny of '/ V�% Notary Public at Large. State of / ` , County of (�
(� n 6 Personally Known /
13 Produced • ,-• , itica 4
i .► PProduced oaf
t 10
Notary Signature. �`��j� `l_
Miry Sign i �' .
41101r T
+ , e SHI'It L GRAHAM
. �. "1g SHIR L GRAHAM t M m y ..,'_ MY COMMISSION # DD 957760
, ' , MY COMMISSION # DD 957760 1 .1::-.....",,,.. T
.1,: ' :,= EXPIRES: February 14, 2014 '
1 ' �'' Bonded Thru Notary Public Underwriters
a.,.,; P EXPIRES: February 14, 2014 4^
COAB FOR'd e_D601: ; :..7 Bonded Thru Notary Public Underwriters
I,'d 91799-LVZ-1i06 sue }s1(S U0Q8u1.(o0U d90 :£0 LO LO deS
JUN -16 -2011 15:25 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/1
NOTICE OF Ia • 1MENCEENT •
(PREP ,. 1N DUPLICATE)
Permit No. i ex Folio No. '
State Of aunty of ') tA..a/ LA 1 • •
To whom k may concern:
The undersigned hereby informs you that • . - mans will be made to cettaht real property, and In
accordance with Section 713 of the Florida - , the following Information is stated In this NOTICE OF
COMMENCEMENT. .
Legal description of property being improved: 3 5 r —_ C" o )--9 E 5 E /1 s,12
I
?C Address of Property being improved: S f CL-1 ' 1 S( i t LAI
•
General description of Irnprovenments: d r ' , ,
)(5 tFCf47 - 1c• f- IC o i' P _ F
w 7ddress SO i c.0 PPet. s N- r p 1 hC' ,-, 1_ ,z, 2, S
Owner's interest in she Off* improvement �,,.� .
i '
Fee Simple Titleholder (If outer than owner) I
Nem 1 '.—. -
Address 1
c)(e Contractor _ .e - 0 4...._ 4...._ 4 i 1 * l J. } � Address •• — .41/ a ' " • ! _� �. �i� f- (_ 3 3.. 4' .
t() Phone No T ?o — 9S`73 1 Fax No. .
Surety gaily) •
Address / . 1 Amount of bond $
Plume No. J - ( Fax No.
Name and address of any person making a loan for . - I Ln traction of the improvements,
Name • / 1 '
Address / I - .
Phone No. / 1 Fax No.
Name of person within the State of Florida, Other than . - if, designated by Owner Upon whom notices or other
documents may be served:
Name
Address 1
Phone No. 7 - 1 Fax No. -
' in addition to himsetf, owner designates the following • - • to receive a dopy of the L "terror's Notice as provided in
Section 713.06 (2) (b). Florida Statutes, (FM in at • s option).
Name
Address / - .1
Phone No. 7 ax No.
Expiration date of Notice of CCfnlrnencement (the exp' ■ • date is one (1) year from the date of recording unless a
different date is specified):
• THIS SPACE FOR RECORDER'S USE ONLY OWNER m7E6112, 1 47
"';; 4 ! :,, do ry Ot eittfe
. ._• _ — _ _ , of Dural, state er floss . hes Persa'+arlY appeared
_ .. by
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goes psrarn
Number PRges 1 aaarrete
Recorded 06116/2011 at 03 36 PM, '
JIM PULLER CLERK CIRCUIT (OtJfiT l IJVAL ' l , �
l * * c 1 .
COUNTY . ' . 1 M �/ pp '� i ,
REC $10.00 y^.�� � ' � r...
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