Untitled ,r 1J
'} CITY OF ATLANTIC BEACH
� s �' i i i
\ 800 SEMINOLE ROAD
f s
)' ° z.:' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 09- 00000357 Date 3/17/09
Property Address 1018 MAIN ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 4600
Application desc
re roof FL3663.3
Owner Contractor
Barth, Tracey ATLANTIC TOTAL SOLUTIONS
1018 MAIN STREET 15153 N MAIN STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32218
(904) 757 -9641
Permit ROOF PERMIT
Additional desc . RE ROOF FL 3663.3
Permit Fee . . . 55.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 4600
Expiration Date . 9/13/09
Fee summary Charged Paid Credited Due
Permit Fee Total 55.00 55.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 55.00 55.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY O FA D TLANTIC BEACH
roc 800 SEMINOLE R ATLANTIC BEACH, FL 32233 09-
V , ,
Pi rE OFFICE: (904)247 -5826 • • FAX NO (904)247-5845
�: � BUILDING - DEPT @COAB.US
;6r. ','� BUILDING PERMIT APPLICATION DUVAL COUNTY
1. J08 ADDRESS: 2. VALUATION OF WORK; 3. SO. Ft. UNDER ROOF
ioi al QIr1 S+ i4/ on. ."
d LEGAL DESCRIPTION L 5. CLASS OF WORK: 6. USE OF STRUCTURE:
1v-314 o1 2S " v c S --,9 t 6i 1,19 I zi p, NEW BUILDING ❑ DEMOLITION Jet
LOT BLOCK SUB DIVISION Sec , . f VD 1q t 11�' t l a ot PCttJ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL
7. DESCRIPTION OF WORK: El ALTERATION ❑ ACCESSORY BLDG. 8, FIRE SPRINKLER:
C �,a. t F 3 (FL . 3 ❑ REPAIR ❑ POOL / SPA ❑ YES ❑ N/A
"� L� ❑ MOVE ❑OTHER ❑ NO
PROP jtY OWNER: CONTRACTOR: ARCHITECT/ ENGINEER:
9. NAME: �f pp 1 gy_i[I N JJ E. 111 I solu.i7hius 23. COMPANY NAME: "Race(' B ate 16.NAM ,/ r � ff LL e vin axo e 11 24. LICENSEE NAME:
10. 1 o , DDRESS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.:
Y iM a.irt $f
18. ADDRESS: 26. ADDRESS:
ld 1C i 'ec h, F/, 3zz33 15153 /J, a ir1 5 - "3 z
11. OFFICE PHONE: 12. FAX NO.: 19. OFFICE P O �' 20. 0A1 _ 3 � � n 27. OFFICE PHONE: 28. FAX NO.:
13. CELL PHONE: 21. CELL PHONE - - (-16‘ 29. CELL PHONE:
14. EMAIL ADDRESS: 22 EMAIL ADDRE SS'. 30. EMAIL ADDRESS:
u) ii ge- faffahlk. CO (l
FEE ow
IF OTHER TLE HOLDER:
R THAN
BONDING COMPANY:
11F oTIaR THAN THAN nit qty MORTGAGE LENDER:
31. NAME: 33. NAME:
35. NAME
32. ADDRESS: 34. ADDRESS: 36. 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, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc.
OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law.
* ** WARNING TO OWNER: * **
YOUR FAILURE TO RECORD A 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
of Agent, Power of Attorney or Agency Letter Required) (Qualifier Only)
f
Signed: 7 vtz_ Date: 3) 1 7 t o ei Signed: ,,,D ate: L I J
I
Before me this `/ y . f ttt / / �j t
y of _Ray �� 2009 in the county of Before me this / ( -y d of _AO Y t D j , 2009 in the county of
Duval, State of Florida, has personally appeared Duval tate of Florida, has personally appeared
a_c Ul tx( -k, -- <e4 in. A -t1 >p.i1
herin by himself / herself hnd affirms that all statements and declarations are herin by himself / herself and affirms that all statements and declarations are
true and accurate. f�J / / �y true and accurate.
Notary Public at Large, State of _[ l , County of 'D.0 vat. Notary Public at Large, State of r , County of _I„J u y a (
❑ Personally Known L✓�- Personally Known
❑ Produced Iden cello __ _ ❑ Produced Identif ation - _
Notary Signet re: Notary Signatur: _ `
pp Nit, Notary Public State of Florida 1 44p, Notary Public State of Florida
BLDG01 Permit Applicat. 9rd I D crown
p ,, My Commission DD801154 , My Commission o L Brown
4 cr c Expires 09 /02/2012 ' x 09/02/20DD801154
NOTICE OF COMMENCEMENT
State of FLORIDA Tax Folio No.
County of DUVAL
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
18 -34 28 -2S 29 E SEC. H 03119 ATLANTIC BEACH
Address of property being improved: 1018 MAIN STREET ATLANTIC BEACH, FL. 32233
General description of improvements: re_ r®oF
Owner: TRACEY BARTH Address: 1018 MAIN STREET ATLANTIC BEACH, FL 32233
Owner's interest in site of the improvement:
Fee Simple Titleholder (if other than owner):
Name:
Contractor: ATLANTIC TOTAL SOLUTIONS
Address: 15153 N. MAIN STREET JACKSONVILLE, FL. 32218
Telephone No.: 904- 757 -9641 Fax No: 904- 757 -3959
Surety (if any)
Address: Amount of Bond $
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER rr??
Signed: 17 fJ Date: 3
Before me this Uday of MAR. '09 in the County of Duval, State
Of Florida, has personally appeared — I - Tr Q ce 13a p `I-L
Notary Public at Large, State of Florida, County of Duval
My commission expires: 09 - - 2012
nally Known: or
Prod ced Identifica
i � 1 go Po Notary Public State of Florida
Robyn L Brown
My Commission DD801154
?
' „e = 09/02/2012