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Permit Roof 1811 Seminole 2012 \ °� CITY OF ATLANTIC BEACH ,.• , J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 4044 , , INSPECTION PHONE LINE 247 -5814 / ' _+ F / / 3A. 4 Application Number 12- 00000121 Date 1/30/12 Property Address _ RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 5500 -r I9, Application desc reroof Owner Contractor MCQUIDKLU Y C/O 8/26/ PREFERRED ROOFING & CONST ROOF 1811 SEMINOLE ROAD 2232 DUNN AVE ATLANTIC BEACH FL 32233 P.O. BOX 24668 32241 JACKSONVILLE FL 32218 (904) 751 -0840 Permit ROOF PERMIT Additional desc . Permit Fee 80.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 5500 Expiration Date . 7/28/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 80.00 80.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 84.00 84.00 .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 1 ( 3 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: S ✓1-D Ie Rd / 11 13( Lt FL 3.2'a33 Permit Number: Legal Description ke - o© • Parcel # • Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ .�i 0 U Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door Use of existing /proposed structures) (circle one): Commercial Residenti.1) If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A Florida Product Approval # -• L 3lQ P ? , 3 For multiple products use product approval form /� Describe in detail the type of work to be performed: PI 4ea a -it avid (( S 1 h ( n y / Property Owner Information: Name: Pa wt A vi. and Address: 57 D (rat'7 E woe City 4 f lci vi ti L 13 r ac (i State Fl Zip 32211 Phone ,773 05'‘f E -Mail or Fax # (Optional) 1 Contractor Information: Company Name: Pre cc( re d ROO- t 4 5 QualifyinLAgent: P-. lz. (114 U SE N Address: 233 2. 1) o ki lit Ave City _ 1 otg State 1= Zip 32 ,21 S' Office Phone 751 6c;44) Job Site/ Contact Number (VS a3 ` 4-4- Fax # 751-6 6 00 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 conznzenced 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 aperiod 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, 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. 1 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 whet • - - i led 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, • of • aw -gulating construction or the performance of construction. fj Signature of Owner 1 ,.1 .� - Signature of Contractor I -"- 44412.9-----. g Z. Print Name F Print Name e-01.) tire. -1 G U NJ Sworiqo and subscribed be ore me Sworn , t� and subscribed bef11' �� me this Day of `. , 20 l � this 1- Day • J , 20 1 Z- l ............a 6 LJf ` Notary Public '� Note • ubiic state of Florida Notary Pu c , Chris Larson Chris Larson y c M Commission EE054618 f c My Commission EE054618 . ''›a o v E ou b ..26.10 ' r o E ' Expires 01/11/2015 NOTICE OF COMMENCEMENT Permit No. Tax Folio 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. De cription of property (legal description of property and ad ress if available): l l i SWM I NOI--& RfJ , Z - Z Z 0-2G .G'`?. 2- 5- 2 ? t.: & - YiN C Lail.-- Li N r 2. General Description of impro ements: Z 3. Owner Information: a) Name and Address: 4Avu V 4 O - 1 DC1 A ry 1 Ea: — 1 ...7.2-3 b) Interest in property: c) Name and address of simple titleholder (if other than owner): 4. a) Name and d Address: ? 4 n _ g ^ v Z-3'5 PLAN/4 A., .. 1A-k 322 t $ a) Name and Address: � �- ' tom -c �t t--.1.(s7 b) Phone Number: / - 7 S 1 . 0 el a 5. Surety Information: a) Name and Address: N b) Phone Number: N A c) Amount of Bond: $ lJ A 6. Lender Information: a) Name and Address: PQ A b) Phone Number: N 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: fJ 4 b) Phone Numbers of Designated Person: pi A 8. In addition to himself/herself, Owner designates N A of id .,4 to receive a copy of the Lienor's Notice as provided in Section 713.13 (l) (b), Florida Statutes. a) Name and Address: fJ A b) Phone Number of person or entity designated by owner: IVA 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 1, 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 113 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT bUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR TI♦ o •OMMENCEMENT. S ? ature of 0 , f i ji i ror Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name & Title/Office . The foregoing instrument was acknowledged before me this ' day of 3 A - CV , 20 IZ, by P MM A UAkrNAO as OWNVIJL- for (Name of Person) (Authority Type, i.e. Officer /Attorney) (Name of Pa Instrument was Executed for) 11110 a*' Notary Public State of Florida NOTARY PUBLIC, ST IG Alt LORiDA ,,,- Chris Larson Print Name: C t�L.Al1�S't h.1 'A z j My Commission EE054618 '"..0,4 a Expires 01 /11/2015 0 Personally Known '�^✓ie ' Identification/Type: Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that 1 have read the foregoinE and that the facts stated in it are true to the best of my knowledge and belief. Doc # 2012019856, OR BK 15835 Page 2404, Number Pages: 1 Signature of Natural Person Signing Above Recorded 01/30/2012 at 03:22 PM, Revised 10/1/2009 JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00