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Permit Roof 401 Skate 2011 tr irm'e sA CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD OAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002773 Property Address Date 10/13/11 401 SKATE RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 6300 Application desc reroof Owner Contractor CUMMINGS SUMMIT ROOFING AND CONSTRCTION 401 SKATE ROAD 1652 EMERSON ST ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 725 -4050 Permit ROOF PERMIT Additional desc . Permit Fee . . . 85.00 Plan Check Fee .00 Issue Date Valuation 6300 Expiration Date . . 4/10/12 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: `fo( SKATE 1 tert -41 r i- Permit Number: Legal Description Parcel # l "7 (S 3 1 -encco Floor Area of Sq.Ft. S F't Valuation of Work $ i Proposed Work heated /cooled n heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door Use of existing/proposed structure(s) (circle one): Commercial - -- If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A Florida Product Approval # FL S i f L ( FL 1 3 8 S 7 - if Et- Z53 3 For multiple products use product approval f orm Describe in detail the type of work to be performed: ' P-ooF Property Owner Information: Nam e E G.v w . k t ia G,..,g Address: 401 S ice4 -'TE City A- -TLN -NnL is State f -Zip 3 ?2 3 � Phone � o4- 7 - E -Mail or Fax # (Optional) ��� Contractor Information: Company Name: Su •$ t T 1Z-ooF 1 0 G Qualifying Agent: ( — i A-tJ EN 0c...0-- Address: ( C, S Z Cif So ST City J bk-c i zS j Vi L-1..� State (t-- Zi 2 Zc� Office Phone 7o 9 - 72S' -- yo b Job Site/ Contact Number loll Z - p 3 ? State Certification /Registration # e.e� 13 z.9 155 Z 5 - �fvS� F ax # r ©� - 7�S_ 385 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 1 certify that no work or installation has commenced prior to the and a void f work is co t mmenced within x will i (6) to or r if construction or of all is suspended or abandoned for aperiod of six jurisdiction. 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 this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction. d C Signature of Owner ���� Signature of Contractor E Print Name rA-t L-,keV tie-'`lE C ..►^ t.,t,,.(..6,S Print Name b/1-1 it- EN./ c!:c__ Sworn tyrd subscribed before me Sworn tw nd subscribed before me this 13 Day of c# 44 0 13E/2 20 1 / this 13=--Day of ec i - 20 // ..rte �i Notary Public 2 d l u `o arY '0 lc a e o once Trisha A Renfroe gm ijimitery pubic State •t Florida ? My Commission DD711559 : t Tristia A Rentroe QfFQj'F 0 . Expires 10/28/2011 .A w My Commission DD711559 r^+dL �x,n �, yr ' .. c�i „r ; Expires 10/28/2011 vised 01.26.10 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. ( l I °C (tr. 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 (legal description of property and address if available): b c 1 'S k A Tr R.. > -; t. 4 1,i, ,-,t1. t44- e- r¢- '" &- 2. General Description of improvements: I.,:' . — le e 3. Owner Information: V( 5i�ff 1 a) Name and Address: G. tfu c ice' FA C C . i 0 , %,11„,j6---,S - eil T! C • ( c d- F b) Interest in property: c o,.. 2-. c) Name and address of simple titleholder (if other than owner): `� •.? 3 9 4. Contractor Information: a) Name and Address: `;a . . tri,,c. l T - . _ , C " /`' ( -` .� I `C f -c" 1 C -, e - L ;S r°--- b Phone Number: ...) 4 t_ f- e - -ti/ v` r c ( s L 5. 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 71113, 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. . t-1 The foregoing instrument was acknowledged before me this ) - day of C ( r( "56�_k. 20 / / 0 `- cw va ( v v. . - r 1 - 4 it '1 4 h }JkWr�� y ... w'P�Y A'EM`�fw":h11� „� f_. 4' !,,,, ∎ 9 l Jamie -- .. -- ~ L Notary PuuLc ,-,t ,, t )t Florida NOTARY PUBLIC, STATE OF FLORIDA y Trisha A Re oboe _ c` My Commission UD71 . S59 Print Name: Vii / c /DJ ,, i ( �%`Ve e~_ Expires 10/28/2011 ;,,,.'v . ❑ Personally Known C4 Identification/Type: /' Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 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. -t 0 4 � 4. # t11 1 «ybt'i OR ti h( "15('3`J- Page 2404, F +`' DOC Number Pages: 1 Signature of Property Owner /// Recorded 10 13/2011 at 01:06 PM, JiM PULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 Revised 10/1/2009