Permit Roof 453 Aquatic 2011 � �� , CITY OF ATLANTIC BEACH
— ' S1 800 SEMINOLE ROAD
!:a " 4 ATLANTIC BEACH, FL 32233
_ INSPECTION PHONE LINE 247 -5814
X1119 -''
Application Number 11- 00002575 Date 9/01/11
Property Address 453 AQUATIC DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4016
Application desc
re roof
Owner Contractor
LEEKS K & D ROOFING & CONSTRUCTION
453 AQUATIC DRIVE 2758 DAWN RD SUITE 1NE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 553 -1381
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 4016
Expiration Date . 2/28/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH
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(� I ROOFING PERMIT APPLICATION
Date: �7 -) --
Job Address: 5 4 fl OG l'1 C- /0r-
Owner of Property: 5 " I y /e_e_,A5
Address: 4" S 3 4 (.1 c- ,) C r - Telephone: "0 3s (a •- 0 7 3
K
Roof Contractor: d dJ I 'L1� State License Number: CCC / 3:3 S'" 1--(-
Contractor's Address: ...2? TS' (--- L 424, e 7. 3
Telephone: %U` 5 /7 Fax: Email:
D
Scope of Work: � XI f Roofing Material 5 qj /e. .
7
FL Product Approval # /v /o 42 6 7 • l 0 Valuation of Work: $ ' /o /6
Required Inspections: Sheathing /In Progress -Dry In / Final
If re -roof: Assessed Value of Structure: $300,000 / _ >$300,000; Roof -to -wall improvements required?
( Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY B FORE RECORDING YOUR NOTICE OF COMMENCEMENT"
i,- / I /', /
SIGNATURE OF OWNER: it I '- • ► Date: % !' / ( OATMAA.
AS TO OWNER: ` Notary Public, 'afm of OMs
Sworn to and subscribed before me this
da of _��C i 20 � «nrnissbn BxpitN sat maim
State of Florida, County of Duval
Notary's Signatur : / / ` ;'t,G l Cam/
personally known
❑ Produced identification
Type of identification produced
SIGNATURE OF CONTRACTOR Date: I -- / - / (
AS TO CONTRACTOR:
Sworn to and subscribed before me this I day of ) e /, , 20 r .
State of Florida, County of Duval a ` C Notary's Signatur .t r
Personally known
❑ Produced identification eg
Type of identification produced My Co
SOS f 1 3, Mu
800 Seminole Road - Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 , Fax: (904) 247 -5845
F: \roof permit applicaton 2010
'4 7TICE OF COMMENCEMENT
State of Florida. County of r)>> t
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance v. it::
Chanter 713. Florida Statutes., the following information is provided in this Notice of Commcncemcn:.
1. Description of property (legal description of property and address if available):
- 7 - 3 —02 --,;( )
( 1C1 j
..�5 3btt�te$•
J. Owner information: J
• •
e n ;caress: y / ?� Y' � t < , '1� � �? . /ic CrT iC' f /77 'lc; t C / C
o) Interest in property: �/ / G'
e) Name and address of simple titleholder (if other than owners
4. Contractor Information: _
a) Name and Aaaress: i OC�iY�t X75', j)av; 0 i `STC1) Uc , Yl 3,-x-:* 7
b) Phone Number: I G H - j , - ? --
V.PS J. Surety Information:
7:-Tame and Address:
b) Phone Number:
Amount of Bond: S
6. Lender Information:
a) Name and Address:
b) Phone Number —
Person within the State of Fierida desi_nated by owner upon tivi ors. notices er other documents ke se..
provided by 713.13 (I)(a) 7, Florida Statutes:
a) Name and Address:,
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive
a cope of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
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 (I) year from the date of Recording unless a
different date is specified:
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 \VITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NO ICE OF COMMENCEMENT.
. h r •• s 1
Signature of Owner or Ot er 's Authorized OffieeriDirectorfPartncrrManager Signatory's Printe Name & Title/Office
r
The foregoing instrument was acknowiedeed before me this / day of ^ 20 /7 . by s
as for 1
(Name of Person) (Authority Type. i.e. Officer/Attorney) (Name of Party instrument was Executed for)
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NOTARY PUBLIC. STATE OF FLORIDA // " • ' • , •
Print Name: Lf,.i
ssion E's*.. $ssS 13, 2014
. Known
= Identification /Type:
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of petjurv. I declare that I have read the
foregoing and that the facts stated in it are true to the best of my knowledge and belief.
Doc # 20 OR BK 15702 Page 686, —
Number Pages: 1 Signature of Natural Person Signing Above
Recorded 09101:2011 at 03:47 PM, Revised 10 /1 /2089
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00