Permit Roof 1632 Main St 2012 1
s \ J s‘ CITY OF ATLANTIC BEACH
r. A r j 800 SEMINOLE ROAD
J
J k =� ATLANTIC BEACH, FL 32233
` INSPECTION PHONE LINE 247 -5814
-»Ji3
Application Number . . . . . 12- 00000231 Date 3/01/12
Property Address 1632 MAIN ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 3900
Application desc
REROOF
Owner Contractor
WINTRODE BRET E JOHN GILMORE ROOFING, INC.
1632 MAIN STREET 11647 GWYNFORD LANE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32223
(904) 880 -8044
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 70.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 3900
Expiration Date . 8/28/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 70.00 70.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 74.00 74.00 .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 O
800 Seminole Road, Atlantic Beach, FL 32233 11/
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: /63? /if,7 / !u Cr Permit Number:
Legal Description Parcel # •
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 3qoo Proposed Work heated /cooled / 3( non- heated /cooled 2ec
Class of Work (circle one): New Addition `Alteratio Repair Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): i Commercial R • - . ' -
If an existing structure, is a fire sprinkler system installed? (Circle one . - - No
Florida Product Approval # • /9'3 -
For multiple products use product approval form - �` ,Q
Describe in detail the type of work to be performed: I — Z O &A/40 d /[LE' /,�1 -C,F
EXt 7 r S /h lead
Property Owner Information:
Name: e7 W 41 Address: /63,2 ` /A be �f _,
City l4 t L,_ rtl Tt S State e.-Zip . 3 3 Phone cog 17 ( Sitit O
E -Mail or Fax # (Optional)
I
Contractor Information:
Company Name: , a i / . / L., , c°. Quali ing Agent: . 1 `44 &'
Address: / /G, < Mci/1/7 1-,q City /t',�edwt!', r State Yl Zip 32 22.�
Office Phone gcryY-270-8U r' T Job Site/ Contact Number 9a ii.._ 9,57,5 Fax # 99q'r 8' -(41 /
State Certification/Registration # cc G O. 7c 7 9
Architect Name & Phone # /01_
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address n
Bonding Company Name and Address ,
Mortgage Lender Name and Address if
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 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 a period 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, Furnaces, Bo 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 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 s ca zed iv : ' or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal .- te, or local regulating . nstruction or the performance of construction.
Signatur- - fawner 43'or i� ____ • ature of Contract. !' j_1.Gc at
may„ - -9 , I - - - V
Print Name -. l Q> Print Name ,,. ,A g e e -.
Sworn to .nd subscfybed before me Sworn toL subscribed before me
this •, . Day of a `► 10k-+r1 , 20 1,1-1_ this 2ti 'Day krfrklEt/ , 20 i 2
,
����.� — • . ►SON
Notary Public \ ' «i CommisslonDD :a0 Notary Public
; , * ' T E, Xp`r Thg iuti'u! Fin 5 Mow"a�.ae s .rolo
��� _ STEPH AI .26 10
.. , ` t Notary Public, State of Florida
i Cornmisslon #06998148
My WM ®Ilpifflg duly iij, 0814
NOTICE OF COQ , r4 "aT
(PREPARE IN QUPUCATE)
Permit No. Tax Folio No.
State of County of
To whom it may concern:
The undersigned hereby informs you that Improvements will be made to ertain real property, and in
accordance with Section 713 of the Florida Statutes, the following Informatior1 Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: /r �� / � � " ;iv
`..Address of property being improved: 3r2 /4/71
General description of Improvement,: Re— roofing
, ^Owner 6l' 7` � , l 1-.Lii" Liar' 1
/_�/ Address -il � ' L � TG , ' Y/ ' i ;
Owner's interest in site of the improvement Residence
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor John Gilmore Roofing Inc
Address 11111 -70 San Jose blvd #196 Jacksonville Fl 32223
Phone No. 9£14 - R8O - 8044
Fax No. 904- 880 -61801
Surety (if any) I
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 e date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONL aF OW =R
1
signe•' : � : � .G � Date
�2 l
46 before - me h- � �!� ••ay ofF�u7 in the
county of - r)LAA ).�.� y State
has personally appeared
Doc # 2012041438, OR BK 15861 Page 1977, t< j 1� . t � _
Number Pages: 1 Notary Publi - - _ e • oun
Recorded 02128/2012 at 09:28 AM, of
JIM FULLER CLERK CIRCUIT COURT DUVAL ,. ;c.u� pu�`• JANE M. RAINER
COUNTY 1 Notary Public State of Florida
RECORDING $10.00 1 ri , My Comm. Expires Nov 2, 2013
Ve��s cif Commission # DO 937034
NOTARY SIGNIr - '