Permit Roof 1865 Live Oak Ln 2011 � " y
t
' ,T : CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
' 01319
Application Number . . . . . 11- 00002485 Date 8/16/11
Property Address 1865 LIVE OAK LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 7000
Application desc
reroof
Owner Contractor
ALFIREVIC, DENISE BLALOCK ROOFING, INC.
10737 NEW KINGS ROAD
ATLANTIC BEACH FL 32233 SUITE 106
JACKSONVILLE FL 32219
(904) 766 -6190
Permit W /W /O BUILDING PERMIT
Additional desc . REROOF
Permit Fee . . . 170.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 7000
Expiration Date . 2/12/12
Other Fees STATE DCA SURCHARGE 2.55
STATE DBPR SURCHARGE 2.55
Fee summary Charged Paid Credited Due
Permit Fee Total 170.00 170.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 5.10 5.10 .00 .00
Grand Total 175.10 175.10 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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/09 -
9i CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date: 1
Job Address: \ U QS L V E o` t L N c
Owner of Property: _ NVY 11 O eN t S - ENI/ v is
/a , A ., 4/_ r p 3 2 - f
Address: _
Roof Contractor: e t' 5 OA - - K , l/ C L
Contractor's Address: 4Oci x� �3rC i (`+wC C�e...._
—
Telephone: /OA —7 (.4 6 Lei i e Fax: 501 — I L
S I, ________ ______------ ------ r „ , / .
Scope of Work: s < , ' n� '1e �`/J ) �1 (�+
1
L I
FL Product Approval # FL oq 1 3, ('a
Required Inspections: Sheathing /In Progress -Dry In / Final �gA /�
If re -roof: Assessed Value of Structure: _ < $300,000/ % Y10
( Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE Cu- CUMmtrvitmtIv I MA nc,ULT IN YOUR
PAVING 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" /
' , Date: v { i'` — / 1
Signature of Owner: .,,t
AS TO OWNER: L
Sworn to and subscribed before me this 1/ day of /J VS7 , 20 // .
State of Florida, County of Duval " " `�/"
Notary's Signature: "^ WILL)AM L POPE
,1' Personally known
Notary Public, State of Florida D Produced identification
My comm. exp. Oct 19, 2011
N0_100 114218 Type of identification produced
, ,�Q
AS TO ACTOR:
Sworn to and subscribed before me this day of , 20 .
State of Florida, County of Duval
Notary's Signature:
❑ Personally known
❑ Produced identification
Type of identification produced
800 Seminole Road Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 " Fax: (904) 247 -5845
Permit Number Tax Folio Number 11/0a- H 10
NOTICE OF COMMENCEMENT
STATE OF FLORIDA
COUNTY OF DUVAL
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement s t' 0,41,`-‘• �o t' -c f'ep�-�-
3 of v9 ` -a 1v�, i
L Description of property (Address): I ( 5 Li Je 04I4 Lv Ai\Gn + ' . 13(c_1 I FL. 3 �a 3 3
2. General description of improvement: NroS
3. Owner information:
1. Name and Address: A E r s (8(05 I-4 o t kA 1c.11 ,Ft.. 3)43.f
2. Interest in property: Own
3. Name and address of fee simple titleholder (other than owner):
4. Contactor's name and address: t't�S IS \l J IoY- 3 W C,'e''f � , i xe Qa. 1 fi[_ n
a. n' 10M- - 74,4- ( I )
/ b. Fax number: C IO' -{ - 1 L - C 1c) I
"9► Surety I on: umber:
a. Name and address:
b. Phone Number:
c. Fax Number:
d. Amount of Bond: ■
6. :Lender's name and address:
a. Name and address:
b. Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other
documents maybe served as provided by 713.12(1)(a), Florida Statutes.
a. Name and address:
b. Phone number:
c. Fax number: —
8. In addition to himself /herself, owner designates of
to receive a copy of the Lienor's Notice as provided in
Section 713.12(1)(b), Florida Statutes.
9. Expiration date of Notice of Commencement (the expiration date is one (1) year from the
date of Recording un - /. - - . late is specified)
Signature of Owner:
Sworn to and subscribed before me this / / day of 2021_.
Notary: c�, t D.2 .—_
L rsonal D shown:
WILLIAM L POPE
My commission expires: Notary Public, State of Florida
My comm. exp. Oct 19, 2011
Comm. No. 00 714216
Doc IT 201 I .i 75e 13, OR BK , s 5082 Page 1417,
Number Pages: 1
Recorded 0811,2011 at 10:47 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00