Permit Roof #16 363 Atl. Blvd 2011 01 v.
, j- 1 4 r
CITY OF ATLANTIC BEACH
J
o 800 SEMINOLE ROAD
0 4 � 4 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002579 Date 9/06/11
Property Address 363 ATLANTIC BLVD UNIT 16
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 6500
Application desc
reroof
Owner Contractor
DAVID MERRITT CONSTRUCTION
1930 RIVER OAKS ROAD
JACKSONVILLE FL 32207
(904) 858 -9400
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 85.00 Plan Check Fee .00
Issue Date Valuation . . . . 6500
Expiration Date . . 3/04/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 85.00 85.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 89.00 89.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
2011 -08 -11 11:29 Building Dept. 247 5845 » 2202573 P 1/1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
y Office (904) 247-5826 Fax (904) 247 -5845
Job Address: „...4 ' :''x' -` .
Permit Number:
Legal Description Parcel #
/ ; ; Floor Area of Sq.Ft. Sq.Ft of Work $ — , Proposed Work heated /cooled non - heated/cooled
Class of Work (circle one): Ncw Addition Alteratio Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) ({circle one): Comm Residential
If an existing structure. is a fire spunkier system ipsta ireie one): Ycs No N /A
Florida Product Approval # 1 ') '( 4' , 1
For multiple products use product approval o rm
1,
Describe in detail the type of work to be performed: s r',C i 'r j )`y kirt
Property Owner Tnfnrmation: ff
Name: ' O MDIrS C. l t t , Address: = � z t;'t /)`f 0, 1J , A --
City ' 4 ,i :' t3(tt i1 State; Zip Phone
E -Mail or Fax # (Optional)
Contractor Tnformation:
'! �r`1L
Company N ie. �� e� : S a 1 , ual ,A
Q tfyiag ge nt: x r
Address: 1 �.� 1 l . 2 i� City ‘-4. 1 r 1l t I 1 t State =- t_ Zip ?2 ? <r d' 4
Office Phone y a/ Y S'") 3 'e" Job Si Contact Number 7 (Li' e'; y .. 7 Fax # �,/ < ,2 G 3' [- sr
State Certlflcation/Rcgistration # C et: 1 ? 5-c iG7
Architect Name & Phone #
Engineer's Name & Phone # ,
Fee Simple Title Holder Name and Address
Bonding Company Name and Address f (
Mortgage Lender Name and Address
Application is hereby made to abtoln a profit to a the work and as indicated 1 ccrt 'that no work or Installation has commenced prior to 1he
issuance e a permit cad that q work will be pe onned to meet the standards of all lows regulating construction in this junsdktion This permit becomes mull
and void ifwork is not commenced within six (6 months, or if construction or work is suspended or abandoned for opened of ste,(6) months at any time after
work is commenced 1 understand that separate permits mast be secured for Electrical Work, Numbing, Signs, Wd's, Poole, Furnaces, Boilers, Ifwlers,
Tanks and Air Conditione.m. eta
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 ORDING YOUR NOTICE OF
COMMENCE ► .
1 hereby eert ib than 1 have read and examined thfrigsplieation and • e same to be true and correct. All provisions spews and ordinances governing this
type of work will be compiled with whether spaci led herein • , The granting of a permit does nor presume to give authority to violate or cancel the
provisions of any other federal state, or toe law • construction or the performance of constructton.
Signature of Owner Contractor Signature of Conttor %� j���
Print Name 4
X 1 . 1 � ,�/f ( Print Name S
Swampland sub bed before pie Swo j � . cn d : e :.►
this inDay of� T.�GGt)f . 20 I , this • e ��/ / 20 /
No Public ''otary ' u to
ised 01,26.10
z Notary Public
Kathleen Marks
Commonwealth of Massachusetts
My Commission Expires on Jan'. 26, 2018
SEP -6 -2011 11:14 FROM: CLERK OF COURTS 904 270 1512 TO:92475845
P:1/1
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NOTICE OF COMMENCEMENT
Pamit Nn.
Tax Folio No.
THE U NDSP.SIQNh n hereby, gives notice that improvement' will be made to certain teal property. and in actordmlot with Section
713.13 ofthc Florida wines, te., the Ibllowing information is provided in this N T ICE OF COMMENCEMENT.
I.Description of property (1egardescripreat .34, 3 'fk,; )" ,, - �� •7 :lCtr/ /-) t% ge3 <:
a) Street (ob) Address: -
2.(ieneral descript;oo of improvetnerrrs: _jkLepteL. µ ry
.t7w+res Information (C
3 (f - ,� - J - _ 1/
a Nam. and addr. hicyo a P!' : ✓�"4 hail l e 8 tit !7 . .,'f43 'cal' z z . 33 ' rp'
b) Name and address of tee simple titlebolder (if other than owner)
c) Interest In property
Plk161-PPli 4.Lonnacior Intbrtnation , .
a) Name and address• aw id q L ✓t H. Cr.); $-f t - co : PD El: \ . r : : :. U(5): 0. a 1 -r
A,
b) Telephone No.: 9 0 t! el -- r1 „c• -I ! L) Fax No. (Opt.)
5.Surety Information
a) Name and address:
b) Amodi of Bond —-^
c) Telephone No.: T Fax No. (Opt.)
6.Leader —_ -,_
a) Name and address: r
1 Phone No.
7. Ideality of person within the Spahr of I or(da designated by comer upon whom cokes or other documents only be ;awed:
a) Name and address:
b) Telephone No.: � Fax No. (Opt)
Sin addition to Meisel& owner designates the ibUowing person to receive a copy ofthc Lienor's Notice as provided in 'Section
713.13(I)(b), Florida Statutes: r
a) Name and address: /
b) Telephone No.: ' F. No. (Opt)
9.E:whinion date of Notice of CotMtnoncetnent (the expiration date Is one year from the data of recording unless a different date
Is specified):
WARNING TO OWNER: ANY FAYNIENT$ MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT AILE CONSIDERED IMPROPER. PAYMENTS UNDER CHAFFER 713, PART L SECTION 713.IJ
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST at RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY B :
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMNIZNCEPINNT.
STATE Or FLORIDA
commit or etwar.t,n:¢ F D.
4t Pl
/ 7fae foregolrxg lnttrtrment wai aclarawledged belbre n,e this day dry of i ll (LO 7� xo ! i . by
... .
1S ?Cl e li %QeiRrApQ.f]as ( typeofanrhority ,eg;,Officer; ,
attorney in Piety Pia i , ' ti , ' r.
.�._ (uamc of parry on If of whom lniati aarent wane aleS}
K wn • '4 C "t�;' ,.. : k
Y fro OR Ptgdpced IdetNiEicatiotl. Notary Signature • . i ih :: ..
A i � / Je �— .�, ..�. •
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Personall ' • � •, .:i ;
J�. f ,, ; ; � f:
Type of Identification Produced Name (prin ce-M! e €h I'l JCS i- 15 ?: i r .
A .
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OR 1 r(. `a. " ,� r
Verification pursuant t o Section 92.525, Florida S t a t u t e s . Under eenaltIm of p e r j u r y , declare that I hovel laid th that a `' ` ' ,
the facts aimed in it ere trot to the best of my knowledge and'belief: V ° x 4Fd 'r '' -. • , •
T•ZRMM t�. r. s l o� : 6 ,
Arran of tOnni PereN signing fa H. ill Ie .) Above ,��'' / ' � i
•
- Notary Publto r _ Kathleen Marks
_ _. _ S ( C,omrnanweanl1 of )Jlassaccfn,setts
Doc x 20 t ('193;17 7, OP. BK 137O,s Page 2209, ' - - ---- =--- on Al 2B, 2018
Number pages 1 _ -
Recorded 09x6/2011 at 11 .28 AM,
6
J1M FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
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