Permit Roof 385 Garden ln 2012 i-- --
CITY OF ATLANTIC BEACH
r ` ' sl 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
< INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000164 Date 2/08/12
Property Address 385 GARDEN LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 8200
Application desc
REROOF
Owner Contractor
HINES MICHAEL E ET AL AND K & D ROOFING & CONSTRUCTION
HENFLING TIMOTHY J JJTORS 1/3 2758 DAWN RD SUITE 1NE
385 GARDEN LANE JACKSONVILLE FL 32207
ATLANTIC BEACH FL 32233 (904) 553 -1381
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 95.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 8200
Expiration Date . 8/06/12
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.
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CITY OF ATLANTIC BEACH
G _ ROOFING PERMIT APPLICATION
!
Date: - p ', .-_
Job Address: ` - 3 s ? ii 1r < e.,,,, L 1 1 i f t 9 0 1 C B e ea e L F2.-
r
Owner of Property: rn ; 0 ka. e I / / 1 y) Q S *' '� ; hi n f J i / e
Address: 3 *8 5 C 0. c c:440 c:440 4` L y\ Telephone: -- � S � l
Roof Contractor: RcA1\ ¢,.Y*t f(, fe_ State License Number: t.. i3 (15a S.)
Contractor's Address: ` oZ - 7 C SZUt u� h 4 3 j 'T .-/- l r L 3 22 ."7
Telephone: 5 7f/ - / - 7--ljD Fax: Email: K`D X.f,c , VA �Zt) Kftyke , ( c_
_ r c
Scope of Work: �`Q � c� ..p Roofing Material S c'N t eLo: [00, S
FL Product Approval # Valuation of Work: S lCTC)
Required Inspections: Sheathing /In Progress -Dry In / Final
If re -roof: Assessed Value of Structure: < $300,000/ >$300,000; Roof -to -wall improvements required?
( Applies to single family structures only) e
0
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'WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYAVG r 7
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND PO.}JD o
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH Y!JR o;
LENDER OR AN ATTORNEY BEFOR • REC' PIN Y • UR NOTICE OF COMMENCEMENT" G al I
tr
S IGNATURE OF OWNER: L / ir Date: l 3 43 i - Q 0 t i e
AS TO OWNER: �, �_ Q O. E
V
Swo to and subscribed before me this 3 day of ,) v\ , 20 /D-- 0 0 0
State of Florida, County of Duval z u
Notary's Signature: ;,. .--,.__0 >
2
0 Personally known
o Produced identification U
Type of identification produced ^� ' y OA �
SIGNATURE OF CONTRACTOR: ---eF ��_ _, Date: / - 3 0 " - J.D --NI fit
NI
AS TO CONTRACTOR: „ My Comm 044 Sworn to and subscribed before me this , day of -J 4-4",.... , 20 1 � -.-
State of Florida, County of Duval
Notary's Signature: w7 \ _ Q_t c_
,ersonally known
0 Produced identification
Type of identification produced
800 Seminole Road Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 - Fax: (904) 247 -5845
F: \roof permit applicaton 2010
NOTICE OF COMMENCEMENT
- • ...a x t.iiJ tVV.
State of Florida. County of Di Iva
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713. Florida Statutes. the followingnrfomation is provided in this Notice of Commencement
1. Description of (t descri on of pro and address if available):
-7 5 .f 4 1,2
r. - :* 7 .-., ui ±icon of improvements:
V;e rce-F US% J ,Shin3
3. Owner lnfonnation: `
{ 1 rvanme ant Address:
Interest in property: f* rol�r q � y � 8 424 . c.
c) Name and address of simple titleholder (if other roan owner): 3 1,12
4. Contractor Information:
a) Name and Aadress: K k n Poccinq 1'758 Pawn Pct i ua 30.0
b) Phone Number. a e4- 541- r700 -
5. Surety Information:
a) Name and Address:
b) Phone Number_
c) Amount of Bond: 5
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 (1xa) 7, Florida Statutes:
a) Name and Address:
b) Phone Numbers of Designated Peron:
8. In addition to himself/herseif, Owner designates of to receive
a copy of the tienor's Notice as provided in Section 713.I3 (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
YO : N'TIC •FC E
gnature of Owner . Owner's uthorized Officer/Director/Partner/Manager Signatory's Printed Name & Title/Oice
The foivguing instrument wa acknowledged before me this , day of , 20 / ')-by
as for
(Name of Person) (Authority Type, i.e. OfcerlAttomev) (Name of Party instrument was Executed for) c
Z 73 4 1
.L .Ll.� -L& DAT ' ' y r* ER NOTARY PUBLIC. STATE OF FLORIDA ' °
Print Name: - 1. -. ., ! a - r Stti Ip
Cersonally Known 1
Identification/Type: yv " I R i k1X zo14
Verification ,� rSK1'a;,
pursuant to Section 92. 525, Florida Statutes. Under penalties of perjury. i+ Il . - ; •
foregoing and that the facts stated in it are true to the best of my knowledge and belief ,
te„ 4/10
Doc # 2012027751, OR 6K 15845 Page 1440, , ./i ` A
Number Pages: 1 Signature ofNawralPerson
Recorded 02/08/2012 at 02:56 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY ;rl
RECORDING $10.00 14
- 1„)