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Permit Roof 1847 Ocean Grove Drive 2011 �, .. CITY OF ATLAN BEACH :. i 800 SEMINOLE TIC ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 ''' ''' Application Number . . . . . 11- 00002341 Date 7/14/11 Property Address 1847 OCEAN GROVE DR Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 6000 Application desc RESURFACE ROOF Owner Contractor SULLIVAN DOMESTIC DESIGNS 1847 OCEAN GROVE DRIVE 438 B FLETCHER AVE ATLANTIC BEACH FL 32233 FERNANDINA BEACH FL 32034 (904) 321 -0626 Permit ROOF PERMIT Additional desc . Permit Fee 80.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 6000 Expiration Date . 1/10/12 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. C 0 , 'i CITY OF ATLANTIC BEACH 08- I I I t 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 r r, OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 a " BUILDING - DEPT ©COAB.US / 1 111 BUILDING PERMIT APPLICATION DUVAL COUNTY 1. JOB ADDRESS: 2. VALUATION OF WORK ; 8. S. FT, UNDER ROOF 7 1847 Ocean Grove 6000.00 4. LEGAL DESCRIPTION: 6. CLASS OF WORK 8 USE OF STRUCTURE: 169598-0100 ❑ NEW BUILDING ❑ DEMOLITION di-RESIDENTIAL LOT _ BLOCK SUB DIVISION ❑ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL 7. DESCRIPTION OF WORK / ' ❑ ALTERATION ❑ ACCESSORY BLDG. 8. FIRE SPRINKLER: 001 4 - 13 REPAIR ❑ POOL / SPA ❑ YES ❑ N/A Wa i?LTS J I ❑MOVE ❑OTHER ❑ NO PROPERTY OWNER: CONTRACTOR: ARCHITECT 1 " ENGINEER: S9. AME: 15. COMPANY NAME: Domestic Designs Roofing 23. COMPANY NAME: te ve Sullivan 16. NAME: 24. LICENSEE NAME: Carlton C. Boyd 10. ADDRESS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.: 1847 Ocean Grove Dr ccc1325504 18. ADDRESS: 26. ADDRESS: Atlantic Beach 438 N Fletcher Fernandina,F1 32034 11. OFFICE PHONE 112. FAX NO.: 1 9 F 1 3 21 N 6 2 6 2 904.32 0. FAX NO.: 633 27. OFFICE PHONE: 128. FAX NO.: 13. CELL PHONE: 21. CELL PHONE: 29. CELL PHONE: 650 .296.8618 904.753.1438 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: bboyd ®domesticdesignsinc.cot FEE 81MPLE HtN:OER: BONDING COMPANY: MORTGAGE LENDER: oF must THAN mot) 31. NAME: 33. NAME: 35. NAME: 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 permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. OWNER'S AFFIDAVIT - I 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 law. *** 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 {K • A • , or Agency Letter Require ' (Quatlle' Orly) gj Signed: 4 f // / At / Date: I I Signed: 6 ii day p Date 20 in the unty of a this t day of i 2.$)67 in the county of Before me is ' �r. Duval, State of Florida, has person appeared / State of Florida, has personally appeared I. Sdf ✓L n &4 (I. 6' herin by himself / herself and affirm at all statements and declarations are herin by himself / herself and affirms that all statements and declarations are true and accurate. U true and accurate. No ry Public at Large, State of �L County of P I) V A ` , Nota Public at Large, State of 1lOY 1 1 4 , County of AlassocA- e/V sonally Known ersonally Known ❑ Produced Identification - ❑ Produced Identficati /+ N /� Notary Signature: Notary Signature: t l ``�'kt It a. Vt..-) 0 P k CYNTHIA A. CROW ,•, MY COMMISSION # DD 796795 TNAM .• %-.: a EXPIRES: June 11, 2012 C AB ' • D 1: RENF Public, State to Bonded Thru Notary Public Underwriters $ ' Al Notary Public, State of Florida Commission #D0998148 Rf, ' �Gr Gc -(mac -! v J '5 gOL � Q/6rrr• My comm. expires July 20, 2014 AZ _ .S ,/fir /1t 4. - / ,t/o c- /2,�i a /L ?v /A y - 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 property and address if available): /J'7 G- e-WA.1 6740 i/6*' 7'Z-- non A&.Ttr, (' ' ( rt . 737-""L 2. General Description of improve ments: ` "�'o �Q=o o 74}-1.0. try%i-Ct 0 5K 0 fro l 1 b 3. Owner Information: r t a) Name and Address: S7 '.4'i I7bSEV /1 r /t/ b) Interest in property: c) Name and address of simple titleholder (if other than owner): 4. Contractor Information: a) Name and Address: ;� _ , ,,.,5 rr Ar 1 , j �+�` X05 o n b) Phone Number: �f r r 5. Surety Information: a) Name and Address: p(4- b) Phone Number: c) Amount of Bond: $ 6. Lender Information: a) Name and Address: /V 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: CCf!? S c- a.-C4 42-b 3 5 c7,2 , .94 k W r c. V1-5 - b b) Phone Numbers of Designated Person: 904 G 8. In addition to himself /herself, Owner designates a copy of the Lienor's Notice as provided in Section 73� (b), Flo Statutes.of to receive 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: 71 3( it 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 1, 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. The foregoing instrument w s acknowledged before me this l' da Yof „6„A., , 20// :ST -1 r tic jietZ (1/ 00C A AI 1 1541JO, tJt^t t3K 'I 5b57 age Number Pages: 1 NOTARY PUBLIC, STATE OF FLORIDA Recorded 07%14;2011 at 03:09 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL Print Name: , .%it4 COUNTY RECORDING $10.00 ❑ Personally Known - L I d e n t i f i c a t i o n / T y p e : S ' 7 ? 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 knowl dge and belie . i01 / r ' • MORAN MAMA WHIN ' f gna - . f Property Owner a. 4 tdY COMMISSION EE 057949 �;:r EXPIRES: May 21, 2015 Banded flru Notary Public Undeiw hers Revised 10/1/2009