Permit Roof 1741 Seminole 2012 t 1 Jl
, 64 ° ✓ 4 ' \ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
07 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000198 Date 2/17/12
Property Address 1741 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5500
Application desc
reroof
Owner Contractor
SAPIA WHITES ROOFING
1741 SEMINOLE ROAD 14262 PLEASANT POINT LN
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 80.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5500
Expiration Date . 8/15/12
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.
S -r
o„ctok BUILDING PERMIT APPLICATION
13 :,,r CITY OF ATLANTIC BEACH
-% J ;31� `' 800 Seminole Road, Atlantic Beach FL 32233
Office: ( -5826 • Fax: (904) 247 -5845
Job Address: 1 / ..
as it A .. A 44 , L ' Permit Number:
Legal Description / i ,,, . R d n4-
Valuation of Work (Replacement Cost) $ 5- 01)
• Class of Work (Circle one): New Addition Alteration Repa' ire
• Use of existing/ proposed structure(s) (Circle one): Commer CR
• If an existing structure, is a fire sprinkler system mstalled? (Circle one): Yes -� N
• Is approval of homeowner's association or other required? (Circle one): Yes No private entity tY re }
Describe in detail the type of work to be performed:
R/456,3
Property Ow ner Information
City ame: Pe-lie'? SA •,' ; Address: 1 7 �`/ 5e7ni, lucre._ 14
State Zip __Phone qp Y 3 _1
Contractor Information:
Name of Company: , R roc", Ca T Ne, Qualifying Agent: T ma
Address: y a , j e e • 4 u jh . te�
• ' v 1 City J4�
Office Phone r D y o Z &p c € y L State ,, Zip ob25
Job Site /Contact Number 333�� � 3
State Certification/Registration # _[C: C. X i O
Architect Name & Phone # �� ffice Fax # 9 0 �{3 3 ` 7
Engineer's Name & Phone #
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work
installation has commenced prior to the issuance of�a permit and that all work will be performed to meet the standards o or
laws regulating construction in this jurisdiction. This permit becomes null and void work is not commenced within fall
months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is (6)
commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, six Pools,
Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. g ,Pools,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEME 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.'
'hereby certif that I have read and examined this application and know the same to be true and correct All provisions o
laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting o a
permit does not presume to give authority to violate or cancel the provisions of any oche federal, state, or local law
regulating construction or the performance of construction. my
10 A
signature of Property Owner: '111\ le
- Signature of Contractor: J.1\
;worn to and subscribed before me
his Day of r_.,.,., 20 a Sworn to and subscribed before me
��'' ee__ QQ;;..,, this 17 Day of F- .0 r..s , 020 / J—
Jotary Public: O ""`^" • • �..., .,�.._ _• •
*` .' ! : c : Notary Public: , j ,
_•: , �• DEEIBl J RITTER
- -` o
'
: MY COMMISSION 4 DD920172 tv9M1,11SS ON 4 DD920172
ZEVISED 03.05.07 .-' ` EXPIRES December 12, 2013 � ' '� «^ MY �O
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-7 4;" EXPIRES Dedemcer 12, 2013
(407) 398 -0153 FloridallotaryService.corn (407) 398 -0153 FlorltlallotaryService.com
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FL County of % / c
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:
17y1 Sc'm; grolde■ gd - CcJ , FL
Address of property being improved:
i 1 y, S ,Y,; i3O1 e, A /am BX / , / = l
General description of improvements:
Re/n.6 tier ex, S t , ,% A0,4 ; N 14/l flew' ' of
Owner ? p.f? _. .ap,cl..
Address 7 _Sr'1,y, j 4J3)c- Rd Al , .Es i p pi,
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor \/l/ h, f/ /S 1in,f ;my 60 _km:, ( 1, „M WA; f e)
Address I VLD Plea .0 ftiV "t P1. L—■ X
Phone No. "1Q Y �2 51 Fax No.
� �c
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. (Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a