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Permits 1736 Ocean Grove Dr (vault) CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 W \ INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00030997 Date 8/16/05 Property Address . . . . . . 1736 OCEAN GROVE DR Tenant nbr, name . . . . . . INSTALL SEWER Application description . . . PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ ZIMMERMAN GRUHN MAY, INC. 6897 PHILLIPS PARKWAY DR.N. ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256 (904) 262-9544 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee 42 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 42 . 00 42 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 42 . 00 42 . 00 . 00 . 00 PEI IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLAN nC BEACH ORDINANCES AND THIN FLORIDA Fj"U L COBCSBU CORES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH r 6� 5 PLUMBING PERMIT APPLICATION Date: Property Address: ��7.3�D �G�C,�zJ (;eo i!G Telephone#: Owner: �l/17� g�i�+) p Contractor: f�yh�J ���1���- - �-'C" Telephone#: Contractor Address: Fax#:_2.&LO&M Contractor Signature: In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, ❑ New list the building permit number: ❑ Re-Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains Washing Machine Lavatory Water Sewer Water Heaters Sprinkler System Other Fees Permit Issuing Fee: $35.00 Total Fixtures: �_ X$7.00 + $35.00= 42 800 Seminole Road .Atlantic Beach,Florida 32233445 Phone: (904) 247-5800 • Fax: (904) 247-5845• http:ilwww.ci.atlantic-beach.fl.us Revised 1/04 t s CITY OF ATLANTIC BEACH, FLORIDA UTILITY PAYMENT PLAN AGREEMENT PROPERTY DESCRIPTION: OWNER: Donna N. Zimmerman 1736 Ocean Grove Drive Atlantic Beach, Florida 32233 PROPERTY ADDRESS: 1736 Ocean Grove Drive RE#: 169614 0000 LEGAL DESCRIPTION: 20-20 09-2S-29E Ocean Grove Unit No 2 S 1/2 Lot 19 TOTAL AMOUNT OF AGREEMENT: $10,280.62 This document shall serve as an extended payment agreement between you and the City of Atlantic Beach, Florida for the above listed total amount and for which said amount will be filed as a lien with the Court of the Circuit Court for Duval County, Florida until the entire balance is paid. CHARGES: Sewer Impact Fees $1,250.00 Sewer Tap Fee 725.00 Contractor 7,293.30 Filing Fees 35.50 TOTAL CHARGES: $9,303.80 TOTAL AMOUNT FINANCED $9,303.80 TOTAL AMOUNT OF LIEN $10,280.62 TERMS: Number of Monthly Payments 60 Due Date Due monthly with your utility bill Billing Included on utility bill Late Charges 10% Failure to pay all charges will result in the water services being cut-off. Payment Amount $171.34 per month Total Interest over term of loan $976.82 Interest Rate 4.00% LIEN: A lien in the amount of the TOTAL AGREEMENT above shall be executed and recorded against the above referenced property. The owner hereby agrees to pay all recording fees and costs involved with the execution of the lien. Upon payment being made in full, the lien shall be released of record. Prepared by and return to: Debra A. Ramsay, Accountant City of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233 REAL PROPERTY LIEN The parties have agreed that this LIEN be filed against the real property owned by Donna N. Zimmerman, and shall be recorded in the official public records of Duval County,Florida. This Lien must be satisfied in full if the property is sold. This LIEN is for financed costs associated with the conversion of a private septic system to public sewer system and including sewer impact fees on the following real property located in Duval County, Florida,more particularly described as follows: Ic RE#: 169614 0000 LEGAL DESCRIPTION: 20-20 09-2S-29E Ocean Grove Unit No 2 S `/z Lot 19 OWNER NAME &ADDRESS: Donna N. Zimmerman 1736 Ocean Grove Drive Atlantic Beach, Florida 32233 PROPERTY ADDRESS: 1736 Ocean Grove Drive This LIEN is to secure payment from Donna N. Zimmerman to the City of Atlantic Beach in the amount of$10,280.62. -�-- Witness (Sign Name) 0 ER: Donna NPmerman ':J-rnyll� Sch I L4 ctc-r- Witness (Print Name) CITY OF ATLANTIC EACH *Jiess (SiA Name) By jffWyjd- bonna Bussey City Clerk Witness (Print Name) Page I of 2 Zimmerman Lien YSR-380 1 tat 09PARTMENT OF BUlLa10GI CITY OF ATLANTIC BEACH l _..,rLt CATION.. I NFC9 A"I' P ` Na� x: 1,014 Adds 17f► nCLA OR DR DRVEu t + r fCI7 IE C :AT­iNTIC' REACH, P`I40RIO #" 2233 jo Tr .W3C�} L W H l ock Lc�t . ! sacd tYS I4: 63eet mn; jubd E� , « p +e 3 l i sx t sud v cin cJ aRc 8 val . . C # to £ , til !,00 -. "" w� » APFLICATI�C� t '� ,° �. .w . PUNIC aces y� yr «� VIE „ i JAY 32,256 'xg« 1 ALL C+�MI�� E F' TQAMS,ANO FOOTINGS MUST 1�1�11� t�, EPt')R� `=IT:1ta1D SIX MONTHS.AF ERp�T 70,ISS a 31KpIi+Ff �AATE {AL, ue�fS AN fi3 B i S:FROM THIS WC39F4 ML ST NOT I�I:ACEfi)1At P�.IEL#G FAC�.A111� � ; c u�Aht MAt1Lt3 iavv ,rTtii :coNTRacTaR,ora € g ; � �� ` ►� ! `'! THE NIEH�►�1C � ► E 1,NO TWIG CLANS WHICH ARE PART,O TFItS Rl�I�IT ©F LAW, NOW I #� A�BACl 8 � l�TMttT Y "p7&M�`�i gCIAT CITY OF ATLANTIC BEACu Budding and Zoning PERT APPLICATION RE ML, ADDITXONS QR ALTERATIONS lzmLITIONS 1a Owner(s) .- V ngyzz Address: `�7✓ .o (p Jl!I/f/hO �' f% Phone: 21 /- 27 y6 - -r.72 Lot # Block or Unit # subdivision: Contractor: �jL�J�}t�/(?f�j(J zzz!6"e&z"� State License # l.? Z4 6 fQi(/f//C Address: Phone No: 9pi6p - 2 Z/7 Describe work to be done: Present use of building: Valuation of Proposed Construction: 500 7,aO Proposed use: Is this an addition? X/ If yes, what are the dimensions of the added space: ft. X ft. Will the added area be heated and cooled? New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUM41T TMM (c0ow-Rcl") TWO (RzSXD=TXAz) 00WzX= 8tT8 or PLMN, MM=MzM SITZ FZAK, SURVZY, X3MMGY clonr FMW, XV=CS Or AND OVA=/C0X RACTOR A271DAVIT, It OWX= XS coNTRBCTR.. Signature OWNER: 'W Date: -q7 Signature CONTRACTOR:-- Date: 1z License Supplied: Liability Insurance: Worker's Compensation Insurance: Notice of Commencement To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this Notice of Commencement. 1. Description of property Folio/Parcel# Sec: Twnshp: Rng: Lot: Block: Subdiv.: J 2. General description of improvements 3.Owner's information: Name:_cC �/M����vf�`��� Address: J 7.7,1" Aez-fi& 1,Q�&Iee 4. Contractor information: Name:Owen D. Cooke Address: 4440 Adamo Dr. Tampa. Fl. 33605 (PLEASE REMIT TO: 3432 CULLENDALE DR TAMPA, FL. 33618) Surety information: Name: N/A Address: N/A Amount of Bond $ N/A 5. Lender information: Name: N/A Address: N/A 7. Identity of person in the State of Florida designated by owner upon whom notices of other documents may be served: N/A 8. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1) (g),Fl. Statutes(Optional) N/A 9. Expiration date of Notice of Commencement(The expiration date is I year from the date of recording unless a different date is specified): A ujij State of: FloricA HaL A/ County of: Si ure. U� .v7iv �oGct Pnnt orType name The foregoing instrument was acknowledged fore me this _ /11__day of�. 1991,by T3frHtjfL��CidGlJ' who is per1gtvtcyme My Comm Exp.IVIV2000 or has produced / as identification and N i " Abath. Prepared by: Janet Jepson American Remodeling Inc. Signat a of otan 4440 Adamo Dr.Tampa,Fl. 33605 li' � �� /1/� Name of Notary printed or typed My Commission Expires: & _//^Z0w /j 4q i , CITY OF 800 SEMINOLE ROAD --- ----- - ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247-5800 FAX(904)247-5805 January 12, 1994 Mrs. Sandra K. MacDonald 1736 Ocean Grove Drive Atlantic Beach, FL 32233 Dear Mrs. MacDonald: Please be advised that based upon a citizen complaint you may be in violation of City Ordinance Chapter 12-1-(1) and (5) (copy enclosed) . The complaint specifies that there is an accumulation of animal feces continuously present in the rear yard of your property. Based upon the complaint this may constitute a public health violation. I am confident that should there in fact be any substance to this complaint that you will take whatever steps are necessary to properly discard, on a daily basis , any fecal matter that may cause obnoxious odors or impede the health of surrounding neighbors . If you have any questions please call me at 247-5855. Sincerely, � arl W. unewald Code Enforcement Of icer KWG/pah cc: City Manager VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED c i` a . (92 CITY OF ALTANTIC BEACH tV COMPLAINT MANAGEMENT SYSTEM �AN 0 71994 i�y7 TAKEN (date/time) : 1- 17- �l / Building and Zoning COMPLAINANT: i_-,-)\1�\,P ("\c�f1 Last Name First game MI ADDRESS: CITY/STATE/ZIP: , 2 TELEPHONE: COMPLAINT: X::4 C�, �+�1J��.J� ,C,� cCY`�A�h SSS 4�1 �� _ LOCATION: y c-__a�c\ PROPERTY OWNERS PHONE: (gbq ) Zy -p PROPERTY OWNERS NAME: DEPARTMENT FORWARDED TO: Oc ,,., COMPLAINT TAKEN BY: G)Lq0,luwl,) DATE/TIME: OFFICE USE ONLY INVESTIGATED: (date/time) ASSIGNED DEPT./-DIVISION: PRIORITY: INVESTIGATOR: CONDITIONS FOUND: ACTION TAKEN: COMPLIANCE: NOTES: V DEPAR TMENT OF 11� CITY,OF AT1.A�i"tiC BEACH Ml apii.M1 •' .:+�4 j �MP Iwo Nre Y.w.ar +w+R+4•k�p+Yf wir?�'; �4 yiT"+ ov ov 7 Mt P ,. y R y{ :TLY A hicP i E+ �3i ' t 0 V s-'� To y A S x= -0f r r t ;y �,. It LDA I q , t' , �. '�. . -00 toots '! h B " t 4 's � f c r � r t `Ft34T "M�lSt Bt3kE 1 r r. E 41D( �A BRfB F THIS WORK WIST�;� ' B C � HAUL b A lb .. GC 1 TRAGt3tI PR tit, mtc WOWS AC jC�'CC'APP B�•P 1�ilVS WHGH ARE PART�TH S '�� • ��Q& � , � t �PKlP LAW " f k Gtea. G Sr i 7 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: / 736 D6e-14d 67/?00e- .�2, 64_ ,F1.,3 OWNER OF PROPERTY: At N I 0-10 L BUILDING CONTRACTOR: rJ A PLUMBING BY JOS PLUMBING CONTRACTOR 695/ lAd= AND ADDRESS: �s'�"=�� Jacksonville, FL 32211 TELEPHONE NUMBER: 670g) STATE LICENSE NO: 6-T6C?(7'2OS 7`- TYPE OF BUILDING: TYPE OF WORK: 2eP/�►C��-►�„1T p ,c OJI� !� SjnlY1 . HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER MSA TOTAL FIXTURE COUNT: x $3.50 + $15 .00 = $ --------------------------------- _ INSTALLATION OF PLUMBING AND FIXTURES MUST BE INACCORDANCEWITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION BEFORE COVERING UP - (904) 247-5834 y, PiA. ti pEPARTIYIENT Of IIUILP1140 CITY OF ATLANTIC OF-ACHgrop ION:, ,� I _ '. ar i" 5 C :. DRIVEr AT e -t Typ s C- 5 ' a wot , NOI, + FR at : I aka + icy T0 ° WOOD ' 3 A a l + s on ed T14 AYC1�Y't�+.i i.� �a #ON LOR 1 01k 3, 422 . SO- x � 4 If " t JAS IN CAPIT MP CV�� ' s�?,C0 1 " CR RCAF w�.. .�� . ry . 1E eu St CARC A "SCC . " Nr R lF' r� � t b� lk E N7FOT E -ALt,CpNCEtETE FORMS AND FOOTINGS MUST,Ba INSMICTESD BEFORE PERMIT VOID SIX MONTHS AFTER DATE t3F4SSUE. E UII?tCl�alG MATERfAI.,RUBEtSH'ANp DEBRIS FROM THIS WORK MUST IVC7T'$E PIA EiD 1N PUBLIC SPACE,AN p Iv"UBT" �tlEAl 9, UP.AND HAULEp%AWAY 13 EITHER CONTRACTOR OR(?a1tNER , F wLURE;Tt CE) ABLY WITH THE MECHANICS' i1EN LAW CAA �iE t� " ► �! A PAYING TW10E FQI s ING ► � ACCOROM, TO APPROVED,PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT la � f3F: P1aGABL 1 ( I i fS QF LAW. `- t LANt BEACH-BUILpING DEPARTMENT r CITr OF ALANTIC BEACH ROOFING FERMI? 11PPLIChTION Owner(s) : FMC Miro �4' 4e' 1736 Address: _ - _t -- _ (kear,GroycYPhone: A�0- �. Lot # , Block or Unit # // Subdivision: Contractor: Alnr'Ingn /-, Oil ( �t1�ut��S 5 rW Address: oda mt I 1 reek_ City, State and Zip Jack<y/n V) Ce,J Phone-2 �" 017y State License PGOdyysKy Describe work to be performed:_ je�--- )eoo-r Valuation of Proposed Construction:_ 4,2q.5o , 0c) Materials to be used:-Ale-ay `��►h�� S Signature of Owner; Signature of Contractor: --- Ao "-� /Z Liability Insurance Supplied Workers Compensation Insurance Supplied License Information CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD =' ATLANTIC BEACH, FL 32233 ., INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Buildingdot&oab.u5 Application Number . . . . . 07-00000881 Date 6/21/07 Property Address . . . . . . 1736 OCEAN GROVE DR Application type description ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4200 ---------------------------------------------------------------------------- Application desc re roof fl 250 . 15 ----------------------------------------------------------=----------------- Owner Contractor ------------------------ ------------------------ ZIMMERMAN WILLIAMS ROOFING OF JACKSONVIL 1736 OCEAN GROVE DR. 6041 LIANA LEE DR ATLANTIC BEACH FL JACKSONVILLE FL 32234 (904) 289-7314 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50 Issue Date . . Valuation . . . . 4200 Expiration Date . . 12/18/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- --------- - ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total 17 . 50 17 . 50 . 00 . 00 Grand Total 52 . 50 52 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. j BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH ti \� �r 800 Seminole Road,Atlantic Beach FL 32233 X135 Office: (904)247-5826 • Fax: (904)247-5845 Job Address: 7 36 06 ec j (P-rove or. 441. C?C 4 . Permit Number: Legal Description 20-Zo dR-2 S -29h. 4e6/ OCe'At, Gro r vo��f /1/02 5110 1-074 /R Valuation of World(Replacement Cost) $ �1 zoo , 00 R B Roa t ' ■ Class of Work(Circle one): Addition Alteration Repair Move • Use of existing/proposed structure(s) Circle one): Commercial en i ■ If an existing structure, is a fire sprinkler er system installed? (Circle one): Yes /A ■ Is approval of homeowner's association or other private entity required? (Circle onei : �es Describe in detail the type of work to be performed: e400iC 5,4,'.,i5/e_ fa S'4,:t Property Owner Information Name: Q U n n c, Address: 1736 O C&n (,-rove_ 0,-. City 44- ,4,*c d egxe t, State f4.Zip 223 Phone 904- Z 147- Y 9 tT q Contractor Information: Name of Company:_ t..i,I//a-," S 1�C c/flr n 5 crF_TC,-,n Qualifying Agent: _T047-, Address: Go W 1-,'A m v, L e e cYr, City 3-a c k-Fvn(111�e State AC- Zip 722 -Tof Office Phone Qd -- Zi?q- 7 3/ Job Site/Contact Number 2 3T- 3Y?/ State Certification/Registration# RC ao O 9 / Office Fax# 2?9 - 7,,T Architect Name &Phone# 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 or installation has commenced prior to the issuance o ffa permit and that all work will be peto meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and vo id work is not commenced within six(6� months, or f construction or work is suspended or abandoned for a period of saa_cf(6) months at anyy time ager work as commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Fells,Pools, Furnaces,li°®iters,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. thereby certify that have read and examined this application 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 o a permit does not presume to give aut le to violate or cancel the provisions of any other federal, .state, or local law regulating construction or pg ante of construction. Signature of Property Owner '�-- Signature of Contractor: r �f /��-- Sworn to and sub ribed before pie Sword tp and subs ed before me . thisZ�Day of 2�° this :U" Day of :t1,y James . Beecher .�'� '��M James T eeche Notary Public: i Notary Public. ' - o �.. a t•• {onO�dTroy fan•(MYI/A6t.blo.Op03b�1ot9 W BonA.ATrgfdnInwrrnCs.lnc 8W-3p5.7019 REVISED 03.05.07 NOTICE OF COMMENCEMENT fate of—F(art'etc, Tex Folio No. ;oUmaty of D Vyq r 'o Whom It May Concern: "he undersigned hereby informs you that i nprovemsnts wdl be made to gain real property,and in accordance with Section 713 of he Florida Statutes,the following information is stated in this NOTICE OF COMMENCEBAENT. Desertion of property being improved: 20- 20 0Q -.Z5 -- 2gF. CX 0eee., Grgve vnr`t / Iq Address of property being improved: - 1736 OC eet,n G ry t•ofe1+4 Qr.• 41.!3C!• 4, 3 Z 2 33 General de§cripfion of improvements• k c_ —jeo o f Owner: Ounetc, Address: Owner's Wiest in site of the improvemm t Fee{�Simple Tifllehol der(if otber than owner): Nam- C1 tr ,` �r'a--+ $ G U•�� nj2F .To c klon v.' Telephone No. goc(— Fax No: 905( Z rj— 73�Y Surdy Cif any) Address: '_._,_ --- _Amount of Bond.# • Nuri 7203816,OR 8K Telephone No: Fiord&Rpages:i 4047 page 120 ft Name and address of any person ma>ciog a Ioan for the RECORDING 4ed 0R8+2f i-%7 a 12:54 pM, Name: S10.00 covR-rQUVAL COUIV7Y Address: Phone No: Fax No: Name of person wifhim.the State of Florida,otic than himself;designated by owner upon whom notices or ouux documents may be served: Name: Address: Telephone No• FwLNo• 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 Statues. (Fill in at Owner's option) Name: Address: �--� Telephone No: FaxNo: Z. Expiration date of Notice of Commencement(the expiration date is one(1)year from the data of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER2, Signed: ••'� �� Before me of in the Co of Duval,State Jarr+le$.T.' Beectier �y i+�:.Cl))R1t171 iQtt;#.QD$88118 OPFlorida.has pet so appcarcd Xpites QCtt�p41`¢�'. phQ Notary Public at Large,mateg F_tLo�rida un r OfDjyml., •� ta+wer firsinaanii, iaosnzuw My commission expires, �iy Personally Known: ��— or Produced.1dentification,44 �y� � CITY OF ATLANTIC BEACH s?� 800 SEMINOLE ROAD =� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 �J1 INSPECTION EMAIL REQUEST: Building,-dept ag7coab.us Application Number 07-00000826 Date 6/13/07 Property Address . . . . . . 1738 OCEAN GROVE DR Application type description ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4200 ---------------------------------------------------------------------------- Application desc re roof fl 250 . 15 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ NEVINS, WILLIAM WILLIAMS ROOFING OF JACKSONVIL 1738 OCEAN GROVE DR. 6041 LIANA LEE DR ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32234 (904) 289-7314 ---------------------------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 51 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4200 Expiration Date . . 12/10/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 51 . 00 51 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 51 . 00 51 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Q v" 1� CITY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION Date: 1 " d Job Address: 175? d f eG h G'roye or, Ate. ✓ a 3 ZZ.3,? Owner of Property: L.�,i �/i p s Li P�'�G� -,d�h S Address: ���Alt P sr Telephone: Z- y 9'- Z 6 Contractor: i R cjolcr `li!� C1,F rGJc X ri C. State License Number: RCCJ 5709 9 8( Contractor's Address: G o q� L. U h -i, L t if Vl. Tq CK-;-o,h I We Telephone: Fax: �o q- 2 6� - 7 36`( Scope of Work: Re "roof Deck Slope: 2//Z/6//Z Greater than 2:12 Ve Less than 2:12 Valuation of work: �{� -100.c/o Product Name(Example:Timberline): / 3U Manufacturer(Example: GAF): C Pr-tA.'h feed' ASTM Designation(s): Required Inspections: She4hin and Final Signature of Owner: ' Q ' DaWW 1^ Signature of Contractor: Date: / C> AS TO'OWNER: Sworn to and subscribed before me this day of State of Florida,County of Duval » J�., James T. B@@Cher Notary's Sipature; Commission#DD598116 Expires October 27 2010 L Personally kn wn �- Bonded Troy Fain-insuanoeinc $00, ao,e ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of C�2C.�- _,2Q�. State g4FIorida, County of Duval ,Sty= James T. Beecher Notary's Signature: rxr-. t*-Commission#DD598116 . Expires October 27 2010 Personally known Bonded Troy Fain,lneoranee.M¢ 000-WDIR ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 1 Revised=1103 NOTICE OF COMMENCEMENT State of /v r, y°ti Tax Folio No. County of D Vye.,! To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and m accordance with Section 713 of the FWA&Stas,the waawi x%infntno axion.is stated in-this Nonni OF COMWxCF.MENT_ Legal Description of property being unproved: 2.0- 20 9 -2_ 9 -2q,6 04eaeadtrvea4 Address of property being improved: /Z 31? 0 Cee r 6-r OL,-e 01'. A41.p?C 4. r4. 3 Z 2 3 3 General description of improvements: f e- f-c7o-F Owner. W-, I lr A"x /tleyt h S Address: 5-CA In e Owner's interest in site of the improvement: k e Sr'ae M (�_ Fee Simple T"rtleholder(if other than owner). Name: o ctor: � �� S y, 1•�C- Ey Address: Telephone No.: 7 3/ Fax No: 20q- 2F9 - 736 y Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person nWcing a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himseit;designated by owner upon whom notices or other documents mw be served: Name: Address: i t Telephone No: Fax No: ( t In addition to himself owner designates the following person to receive a copy of the Lie ccs.Notice as provided in Smoot 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiratton.date is one(l)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY O K Signed: "� Date: //:2 b Before this ^day of _ a- in the CO of val, tate Of F has personally appeared- Notary Public at Large,State; Flo ' ofal. My commission expires C Zile! Doc#20071 .OR BK 14031 Page 1585. Personally Known: NW&W,Pages:i Produced Identification:' � or Filed 8 Recorded 08x1312007 at 11:58 AM, rr JIM FULLER CLERK CIRCUIT COURT DUVAL a eoed�a s =27 boo 01 COUNTY RECORDING$10.00 t � STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this day of �T1/1✓��, 2005, by D::�)YlY)Gv 2i Y�'� i'Y1Ch�11 and by -------- , who are personally known to me or produced FI--DIS- 2.51-o fir- L4 -E5 —5 9-S— a as identification, and who did/did not take an oath. Imio" -- 0A&;J0,A 'f3aVM-L� �sN ate tz13� N t Public, tate of Florida ^" E7EPfFS 1�ay�T,2006 My Commission expires: IQ �aThurane,�ua.nw�ra. tr fyy 1ENNIFER SCHLLIETER My COMMISSION$DD 121301 EXPIRES:May 27,2W6 Bonaatl Thu NaWry Publ c Ik t. Page 2 of 2 Zimmerman Lien