Permit Roof 2131 Fairway Villas 2012 ` rzZ CITY OF ATLANTIC BEACH
's. 800 SEMINOLE ROAD
1 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . 12-00000276 Date 3/13/12
Property Address 2131 S FAIRWAY VILLAS LN
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . . 4950
Application desc
reroof
Owner Contractor
KANG TRUST PRO ROOFING & ASSOCIATE
25 RUTH DR
ATLANTIC BEACH FL 32233 PALM COAST FL 32164
(386) 931-0497
Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . . . 00
Issue Date . . . . Valuation . . . . 4950
Expiration Date . . 9/09/12
Other Fees STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 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
Office(904)247-5826 Fax(904)247-5845
Job Address: 2131 South Fairway Villas Lane
Legal Description 39-22-08-2s-29e Fairway Villas Parcel#39-22-08-2s-29e
Moor Area of Sq.l t. 2200 Sq.Ft
Valuation of Work$ 4950.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
C
Use of existing/proposed structure(s)(circle one): Commercial \,�esi
If an existing structure,is a fire $rinkl r syyst9m stalled?(Circle one): es No N/A
Florida Product Approval# �` ` r`t'
For multiple products use product approval form
Describe in detail the type of work to be performed:
REROOF
Pronerty Owner Information:
Name: AZALEA KANG(KANG TRUST) Address:2131 S FAIRWAY VILLAS LANE
City ATLANTIC BEACH State FL Zip 32241 Phone 904-477-5475
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:PRO-ROOFING&ASSOCIATES Qualifying Agent: �a.��a
Address:10752 DEERWOOD PARK BLVD City JACKSONVILLE State FL Zip 32256
Office Phone 904-394-2959 Job Site/Contact Number 386-931-0497 Fax#_904-394-8383
State Certification/Registration# CCC1328416
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. 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 sus ended 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 ElectricalpWork,Plumbing,Signs, Wells,Pools,Furnaces,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 YOiJR NOTICE OF
COMMENCEMENT.
I hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of aw•a .ordinances governing is
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to gi , t rity to violat 'br cant the
provisions of any other federal, ate,or local law regulating construction or the performance of construction.
6ui
Signature of Owner Signature of Contractor /
Print Name ,/ a 11•i
Doc#201 051606,OR BK 15874 Page 1559,
Number Pages: 1
Permit Number: Recorded 03/09/2012 at 11:2 AM,
Folio/Parcel Identification Number: 39-22 08-2S-29E JIM FULLER CLERK CIRCUIT COURT DUVAL
Prepared by: COUNTY
Return to: PRO ROOFING&ASSOCIATES INC. RECORDING$10.00
3024 KANANWOOD COURT,SUITE 1008,OVIEDO FL 3276
NOTICE OF COMMENCEMENT
State of Florida,County of DUVAL
The undersigned hereby gives notice that improvement(s)will be made to certain real property,and in accordance with
Chapter 713, Florida Statutes,the following information is provided in this Notice of Commencement.
1.Description of property(legal description of the property,and street address if available)
39-22 08-2S-29E FAIRWAY VILLAS,2131 FAIRWAY VILLAS LANE,ATLANTIC BEACH,FL
2.General description of improvement(s)
REROOF
3.Owner information
Name: AZALIA KANG Telephone Number: (904)477-5475
Address 2131 FAIRWAY VILLAS LANE,ATLANTIC BEACH,FL Interest in Property OWNER
4.Fee Simple Title Holder(if other than owner shown above)
Name: N/A Telephone Number:
Address
5.Contractor
Name: PRO ROOFING&ASSOCIATES,INC.-ELMER CAMPOS Telephone Number: 407-542-5903
Address 3024 KANANWOOD COURT,SUITE 1008,OVIEDO FL 32765
6.Surety(if any)
Name: N/A Telephone Number:
Address Amount of bond$
7.Lender(if any)
Name: Telephone Number:
Address N/A
8.Persons 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. ..— '"--~
Name: N/A Telephone Number:
Address
9.In addition to himself or herself,Owner designates the following to receive a copy of the Lienor's Notice as
provided in§713.13(1)(b),Florida Statutes.
Name: N/A Telephone Number:
Address
10. Expiration date of notice of commencement(the expiration date is one 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 YOUR NOTICE OF COMMENCEMENT.
11. (2d.,,//'r"/ f Lf
Sig ure of Owner Signatory's Printed Name/Title/Office
(or Owner's Authorized Offic Director/Partner/Manager§713.13[1][d]) A � LCJ�I G— �a as
The foregoing instrument was acknowledged before me this ` day of �' by
(month/year) (name of person)
c.o.; t.,.-.)- v' for
(Type of authority,e.g.,officer, r}i tee,attorney in fact) (Name of party on behalf of whom instrument was executed)
i
NCam..^...-(,te 631., 7 N 0
"""'' MARIA Y.FLORES
Signature of Notary Public—State of Florida iP`�v.;`�' Notary Public-State of Florida
Personally Known OR Produced ID 'L \ t t. „ �! a, my Comm.Expires Apr 8,2015
Type of ID Produced '�,'+r���, Commission oe EE 75158
Verification pursuant to Section 92.525,Florida Statutes:Under penalties • oregoing and that the facts
stated i it are,yrue to t best of my knowledge and belief.
r� - � Form Revised:11/20/07
S e of Natural Pening on Line 11-Abov