Permit Roof 315 19th St 2011 ° °Pr,r s r CITY OF ATLANTIC BEACH
r `e J
sy 800 SEMINOLE ROAD
J =� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002496 Date 8/15/11
Property Address 315 19TH ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 11000
Application desc
REROOF
Owner Contractor
FORD, ROBERT ALPHA CONSTRUCTORS LLC
315 19TH STREET 1922 PHOENIX AVE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32206
(904) 469 -0668
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 105.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 11000
Expiration Date . 2/11/12
Special Notes and Comments
NEED RECORDED NOC PRIOR TO FIRST
INSPECTION
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 105.00 105.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 109.00 109.00 .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
Joh Address: 3/S /9 t` Sfted7 /{¢/G•,-A ` C rL 3 22_33 Permit Number: // Z 504
Legal Description /24 '7, P/a_i 3 , Se %a lLla' '-r 0 N Parcel # l'?-2 010 - 092-2_
Floor Area of SqJ t. Sq.Ft
Valuation of Work $ /1, pap Proposed Work heated /cooled Z a-5 non- heated /cooled (/ y
Class of Work (circle one): New Addition Alteration Move Demolition pool /spa window /door
Use of existing/proposed structure(s) (circle one): Commercial ' eside r
If an existing structure, is a fire sprinkler system installed? (Circle one): ' es N /A
Florida Product Approval # F 7-0 1
For multiple products use product approval form
Describe in detail the type of work to be performed: ,1 e'otl- S" /.es
Property Owner Information:
Name: 0-be C?: Foril Address: S /3 — /9 2P-e2I- r44/ 'Jii+ &4c.4
City 4-t1 r !-.` Staters- Zip 322-33 Phone
F -Mail or Fax # (Optional)
Contractor Information:
Company Name: /4-/J4l r r4-f r` Qualifying Agent: Ve ,9et4y ft- lavoZOv
Address: /92_2 /)j oei,r`yr /�vL City ; eLc&soi u /t State Ft- Zip.32Zb(
Office Phone r y y6 y L (4 Job Site/ Contact Number fo Y t/` y 04 1 g Fax # 31/ 2'V' 6'3 4/8
State Certification /Registration #
Architect Name & Phone # /
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address S C+ 4M t-. 4 1., 6
Bonding Company Name and Address Ai/AI-
Mortgage Lender Name and Address
4pplication 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
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 77ot commenced within six (6) months, or if construction or work is suspended or abandoned for a_ period of six f6) months at any time after
work is commenced. / understand that separate permits must be secured or Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo 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.
I hereby certify that / have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
lope of work will be complied with whether specified herein . ..t. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal"IP/
st. - • r local la • • ul • • g constru, tion or the performance of construction.
Signature of Owner % Signature of Contractor s „ - -
Print Name x R tP e- Print Name Ye t, ez.t `i /
Sworn toed subscri d�bbef� ore me Sworn t and subscribed _before me
5::=-Day --Day of i � , 20 /" this .f Day of , _before 20 -l/
v i ta i 1 / , ,f ry
'ry Public 'A , MY COMMISSION # DD 929496
No 4 SVETIANA BRATUUN
-n ' ...; a EXPIRES: November 8, 2013 *-. MY COMMISSION # DD 929498
'AVONJUVORMAINFOSISF p ' Bonded Thru Notary Public Underwriters * Y EXPIRES: November ROIE4Se . 01 .26.1
F ' Fronded Thru Notary Public Underw hers
NOTICE OF COMMENCEMENT I Number r l a 2 OR BK 15697 page 1493
I Number Pa
IM FULLER C K CIRCU T OURT DUVAL
COUNTY
Ptltillt NO. j RECORDING $10.00
Tax Folio No.
1
THE UNDERSIGNE' hereby gives notice that improvemen will be made to certain real property,
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. ante with Section
I .Description of prop rty (kga[ description): ` 9 PI •‘k. 3 ' ' 8 l 8 (IN /.9,
a) Street (jo l Address: t 1 sd - 4 +/Q k) . ge
2.General description of improvements: /�. f t e it S4. CSC 3 2233
3.Owner Information 1
I ■
a) Name and .:ddress: /2oier1 y-2„rd 7I / y14
b) Name and ddress off simple titleholder (if oth r than!owner) fr/
c) Interest in .roperty �_e.. 3 hr.
4.Contractor Information
a) Name and :ddress: �D1�� L,tm, ,,,..,e�,3 I / ,p .6._ _ Te.r�a 1&
b) Telephone o.: �j +� ,
5.Surety Information U6� 16 8' ' i Fax No. (Opt.)
h) Name and ..dress: PA.1"
),Amount of Bond: ;
c) Telephone o:: '
6.Lender I FaC No. (Opt) ,
a) Name and .ddress:
I Phone No
c
7. Identity of person wi hin the State of Florida designated by weer• > ipop whpm notices or other documents may be served:
a) Name and ..dress:
b) Telephone o.: • 8.In addition to himsel owner designates the follow perso t recbit�e • a copy of the ,iengr's Noti as provided in Secti
7 1 3.13 (I)(b), Florida S t a tutes: ton
a) Name and . dress: 1
b) Telephone o.: _ '
Fax No (Opt) pf
9.Expiration date of No ice Commencement (the expiration date ii one Year from the date of recording unless a different date
is specified): I
WARNING TO OWN R: ANY PAYMENTS MADE BY 'I1HE OWNER AFTER THE EXPI
COMMENCEMENT RE CONSIDERED IMPROPER P,4fYMENTS UNDE1(t CHAPTER 713, ART I SECTION 713.13,
FLORIDA STATUTE AND CAN RESULT IN YOUR PAkING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COM ENCEMENT MUST BE RECORDtD AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF VO INTEND TO OBTAIN FINANCING, CONSULT YO ' ENDED O: . • EY BEFORE
COMMENCING, WO ' K OR RECORDING YOUR NOTICE OFICO CE , N y •
STATE OF FLORIDA / /�
COIINTYOF['}foFE�E7tt OA 1.- 1B I �
Sign Ifr . I fOw : o! f : , • uthorizzd 0 II . tor/Partner/Manager
(Print NAtrj — __
The foregoing instrumen was acknowledged before me this / t
.if of 14474- 20 //
as et...Me✓
(type of authority, e.g. officer, trustee,
attorney in fact) for
(mime of party on alf of whom instrument was executed).
Personally Known / u R Produced Identification N otary Signature - of &`'a_' #64,42711e
Type of Identification Pr..uced i Lame (print) st/ETL neol g, ,,,,/
OR
Verificatio�t pursuant to S ction 92.525, Florida Statutes. Under �enaltir}s of perjury, 1 declare that I "" _
the facts stated in it are t e to the best of my knowledge and belief I thNY
is..: , EXPIRES.
FORM S/NOC,rvsd2010
'Va. Bonded Pau Notary November g tlllt111 eery
ignature of Natural Person Signing (in line # 10.) Above
i
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