Permit Roof 394 Sargo 2011 ! R�
.. 1
f; 11�,
f j � CITY OF ATLANTIC BEACH
:=; ?. 800 SEMINOLE ROAD
1 „ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
- 013
Application Number . . . . . 11- 00002642 Date 9/19/11
Property Address 394 SARGO RD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4200
Application desc
REROOF
Owner Contractor
HENDERSON ROBERT ARTISTIC ROOF SYSTEM, INC.
159 11TH ST 2146 ACACIA RD
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 233 -8231
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 4200
Expiration Date . 3/17/12
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 t/ -i
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 it,
Job Address: .294i SG c Sc P 1uc -icc/) f T Permit Number:
Legal Description Parcel #
120 Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ V200 Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Move Demolition pool/spa window /door
Use of existing/proposed s • , ure(s) (circle one): • smmercial Residential
If an existing structur: s a fi • s • rinkler s : • costa e s " cle one): Yes No N /A
Florida Product A. 'royal # *, AC
For multiple pr r • ucts use product approval form
Describe in detai ■ e type of work to be . e • - • :
Property Owner Information:
Name: AA., r A k ,kolerso ✓1 Address: 39 54 fS e, R ot
City .4 - c State - A/Zip Phone 90t/ '7 (0 - 74b_s —
E -Mail or Fax # (Optional)
Contractor Information: L JI j
Company Name: / r � j .C o- Stj ' 4rYVi s Qualifying Agent: j - -b Or A. Oa G` S h
Address: City Jet t kCfo» V rit -c State 1/ Zip ,e2.2.2
Office Phone 96 L/ /41r-7(.4? Job Site/ Contact Number qp '-7 .z( dtV Fax #
State Certification/Registration # (, C t.? SS
0
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortme 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 performed 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 separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, 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.
1 hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o r r
work will be complied with w • •,•r s.ece, herein or not. The granting of a permit does not presume to gi authori• o violate or cancel the
provisions of any other federal, stag, or I ,ca aw re: lating construction or the performance of construction.
i � IMO Signature of Owners / / - Signature of Contractor ■ � Ati„
Print Name Q X Pe nY D Print Name h j Q tg . sty r1
Sworn to nd subscri d before me Sworn to and subsc ed before me
this) ay of f. , 20 1) this j_2__' —tDay of f , 20 11
,----- J
j t
N y u to o ary Public
DENNIS CROSBY
DENNIS CROSBY Revised 01.26.10
MY COMMISSION #11011223 MY 4 ;6 , H P" '' 1 '1 , #11011223 EXPIRES: JUL 25, 2014
'IRES: JUL 25' 2014 ` Bonded through 1st State Insurance
EXPIRES:
trough 1st State insurance
NOTICE OF COMMENCEMENT
Tax Folio No.
Permit No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property (1e 1 description of property and address if available):
i t
yc.t 1 T 7i:: . stiC C ) \T r) €6 l ) J \ 1
2. Genera,Description of improvements: E
c:'': C 1� t (, (. -r
3. Owner Information: �.`• ' t
1 { ���
a) Name and Address: '. ;. - . - ^....: . M ,
b) Interest in property: % f: C t
c) Name and address of simple titleholder (if other than owner):
4. Contractor Information: 'T, ;\ c ' '
Z a) Name and Address: S �I
b) Phone Number: ck�-/ �4 "5 _7( L.
' \Surety Information:
a) Name and Address:
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address:
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(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 copy 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 (1) 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
}l' S` ,20 )i
The foregoing instrument was acknowledged before me this � � day of
DENNIS CROS9Y -
4i r r Ad7 C OMI+i1SS10N ,0►EEO11223 TARY PUBLIC, S ATE OF FLORIDA
Boer through Insurance Print Name: DL. w'' ..... Q- 0-0 >
p ersonally Known
❑ Identification/Type:
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of • : 'ury, I decl a that I have read the
foregoing and that the facts stated in it are true to the best of my knowledg a • b- of
,,,,,,
) t
Doc# 2.01 'I'! " 24, VR E3K1570v Page 1b72. : tgna ireo Owner
Number Pages 1
Recorded 09i12i2011 at 12:45 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
Revised 10/1/2009