Permit Roof 318 Skate 2011 ‘j 3 fr. \\.s CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
0 ;,e ATLANTIC BEACH, FL 32233
, , . ,,, m °. e INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002984 Date 12/09/11
Property Address 318 SKATE RD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 8100
Application desc
reroof
Owner Contractor
BURTON, MIRIAM CARLSON ENTERPRISES LLC
318 SKATE ROAD 932 CANDLEBARK DR
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 370 -4180
Permit ROOF PERMIT
Additional desc .
Permit Fee . . 95.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 8100
Expiration Date . 6/06/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 99.00 99.00 .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: El 8 Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.F't
Valuation of Work $ 8 0 Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Additio Alteration Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial CResidentialTh
If an existing structure, is a fire sprinkler system installed? (Circle one): es o N /A
Florida Product Approval # FL. /06
For multiple products use product approval form
Describe in detail the type of work to be performed: Qp• oo E
Property Owner Information:
Name: m ►r'A.r ' uoS tee Address: X1 S kid e 12�
City A-i-lp �� �� Sec4c k State FLZip 32233 Phone 904 3 03 02 6S
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: G World ll,C Qualifying Agent:
Address: SU Ward WAWA HAIM City State Zip
Office Phone (904)5274662 Job Site/ Contact Number Fax #
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. 1 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 f 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. 1 understand that separate 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 BEFOR CORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereb certify that 1 have read and examined this 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.
Signature of Owner IL .. • a ����� t Signature of Contractor /
/4t p h..,.,L...�ad-sort
Print Name ��l f�O..Y� � � Print Name ` '�1 ........... �.
Sworn to and subscribed befoe me Sworn to and subsc ibed before me
this Day of Oee - t1 ? , 201 I this 5 Day of V G•e/A,h,r , 20
ARCHNA PATEI ARCH PATE
rr
Notary blic `: M COMMisst Notary lic =`: .' MY COMMISSION # DD7
EXPIRES May 19, 2012 � EXPIFMay ��, 201
,,,, R evt e �4 ' k;
(407) 398 -0l53 _ . FiorkfallotaryService.com (407) 388 -0163 Flo a o ry ry x=
Doc # 2011260617, OR BK 15785 Page 1462, Number Pages: 1, Recorded
12/02/2011 at 01:39 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10,00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No Tax Folio No.
State of ' County of DLit Ulf ft L_
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 Fonda e following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
Address of property being improved: _ ?' Cl SkCC `— 1( Z &. 1 7 -\ ct C kea C k F L-
3 �3 Q rr
General description of improvements: RQl�GC
Owner r() i % f 10.r c' to (\ ,
Address .3\(1 S1�C RA, a \ (\ - �Qach FL X2233
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address pp����
Contractor O&M F to r,�.,.... � LLC
Address B Rickard LaJac oaville*FL37116
Phone No. (904027 -1662 Fax No.
Surety (if any)
Address Amount of bond $
Phone 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
Phone 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 Statutes. (Fit in at Owner's option).
Name
Address
to
Phone No. Fax No. m eN
w r 3
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a
different date is specified): c
THIS SPACE FOR RECORDER'S USE ONLY OWNER Q O 3 T
Signed: re vV-rut 1r' DATE // i l l z
Before me this a day of ('IC:tOfAD r- /// in e U 2 p- a I
County of Duval, State et Flo `i da, nas personally appeared 2
�,
rtC — C'e -n _ herein by 0 X `
himself/ herself and affirms that all statements and declarations herein U al
are true and accurate >-
2 • •
d - 'AEi
No ary lie at large, State of County of if 'q
My commission expires. S IGI —/ V ';,, ▪ ,
Personally Known or
Produced Identification (= C-.ttr)