Permit Roof 344 4th St 2011 � CITY OF AT BEACH
800 SEMINOLE ROAD
-r I ATLANTIC BEACH, FL 32233
x INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002616 Date 9/13/11
Property Address 344 4TH ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4451
Application desc
ROOF
Owner Contractor
YOW, RONALD HOWARD CONSTRUCTION LLC (ROOF)
344 4TH STREET 580 WELLS RD STE 3
ATLANTIC BEACH FL 32233 QA HOWARD RAYMOND CUMMINS
ORANGE PARK FL 32073
(904) 541 -1112
Permit ROOF PERMIT
Additional desc .
Permit Fee 75.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 4451
Expiration Date . . 3/11/12
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: ; � - I �, L, + 1 Il ,y - v - (,(1 Permit Number:
Legal Description S ` 2 i 1 i`) - 2.`i( 1bT L ()Ni i 1 61 t3U
LOT 1 S LSParcel # t So -
t- 9 `i 1 - 0 000
, , Floor Area o e heated /cooled
Valuation of Work $ � � � r, . ] 1 Proposed Wor k heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition poollspa window /door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval form f
Describe in detail the type of work to be performed: y e / 60 ( `Vl O 1 - ") (01 �,� l ■ A -( f
Property Owner Information:
Name: (>nako C \ 4 U1C , C( 1. IC1�.i 0 Address:(9)1 ooC s i Une. ( h
cit ( 1 '11 Statcl,Zip?,UO U 1 Phone ( 1 < 4 � L\ $ $ - Z `''t
E -Mail or Fax # (Optienal)
Contractor Information:
Company Name: \ Al)v1()kVA Ql1 Sr Y1,l (1) 0(1 l .1 ,( Qualifying Agent:
Address: ,St 0.3 \� 6' L0Ctoa Ci 0Y dV1 f - State r- L Zip /0'73
Office Phone it ,$ � 1- 1 III_ Job Site/ Contact Number t t� -` 2U .-ax # ei(kq S N 1 - l 1 U _:j
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and 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 perfonned 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 sepa permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, 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 I have read and examined this a plication and know the sane to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether sppeci red herein or not. The granting of a permit does not presume to give author' ' to violate or cancel the
provisions of any other, e • tate, or local law regulating construction or the performance of construction.
Signature of Ownner Signature of Contractor ,- AIIIIIe
/ C- ci7tt �� I` ` DO 1 Print Name Print Name l ow.
Swor to and stt4 cribed • , ore Sworn to and subs ribe• befo }}`e e
this/ - Day o �,i 20 / this 17- Day of ; i. , A ■ , 20 11
Notary Publ , , ..,, . , •
y Scott , Commission 0' •u otary Public State of Florida
4cIr 1 s< Ex Commission DD875212 :° kt R:. i sed 01.26.10
Of . E xpires 03/29/2013 , Jennifer Koski
< My Commission DD928560
a"ti" '? p Expires 10/27i2013
lNc:,ILoibli ,
,
NOTICE OF COMMENCEMENT S E P 0 � ?fl
Permit No. HOWARC1 CONS RurH
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description): % - l0 I - 7.S - Z`l£ AT Lill, T'1( 1 Cr1(14 LOT 1 QLk S
a) Street (job) Address: ' 6 II la . L O ■ L _
2.General description of improvements: ftl 0 0
3.Owner Information .
a) Name and address: Q lGl 3 LAY Ck1 fit \■ 10( (91A ii (Y(( ,5111)( Pt 1 Cvtvw\11 PA 3(x( -1
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4 .Contractor Information ,
,0�la Name and address:4 t VC\ (Oil (A'1 0 n LLB � 6v 3 �1 121 G } 'JG�V� �� � P I YI. r( 3�u 1
b) T elephone No.: l -I 3L 1 - I I Fax No, (Opt.) / — I ( U
5. Information
a) Name and address:
b) Amount of Bond:
c) Telephone No.: Fax No. (Opt.)
6.Lender
a) Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
S.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one 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 I, 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF • ,
COUNTY O • IN Notary Public State of Florida z 1 • - 1
a r Jennifer KoSki Si atuie of Owned Owner's Authorised Officer /Director /Partner /Manager
., c_ . ` My Commission 00928560 I 10,1A1(1
4710, f< Expires 10/27/2013 (- l t t (k, -"
Print Name .)
The foregoing instrument was acknowledged before me this 1 day of ' pi-t. l�a11 h' ii ' , 20 (' , by (1\0, 1 c"4i 1 L>, i #{ (...
as ((, U61 \. `. ' (type of authority, e.g. officer, trustee, f
attorney in fact) for 31 L I t l) c - ,, , (2' r' 1 (name of party on behalf of whom 'nstru ent was executed).
Personally Known " OR Produced Identification Notary Signature, L. � ,1.; F u. L-t
Type of Identification Produced Name (print) ,) t. i1� }t 4' k.= � I � -1
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that 1 have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
Doc tF 201 I i 99305, OR' i3K 1571 1 Page 783, Signature of Natural Person Signing (in line # 10.) Above
Number Pages. 1
Recorded 0913.2011 at 02:30 PM.
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING 510.00