Permit Roof 596 N Nautical 2012 r c [A,A f CITY OF ATLANTIC BEACH
r) 800 SEMINOLE ROAD
:J r Z ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
"s -J13 9
Application Number 12- 00000376 Date 4/04/12
Property Address 596 N NAUTICAL BLVD
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 7600
Application desc
replace shingle roof FL 10674R -5
Owner Contractor
BLACKWELDER, JOHN W CARLSON ENTERPRISES LLC
596 N NAUTICAL BLVD 932 CANDLEBARK DR
ATLANTIC BEACH FL 322334119 JACKSONVILLE FL 32225
(904) 370 -4180
Permit ROOF PERMIT
Additional desc . REROOF
Permit Fee . . . 90.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 7600
Expiration Date . 10/01/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 94.00 94.00 .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: SY y40i/ew vim' /1/. iiii**06t4 03 Permit Number: / e.- 3 7
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ ? O Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration • epair Mo - De lition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercia Resi s - •
If an existing structure, is a fire sprinkler system installed? (Circle one): es No N /A
Florida Product Approval # j /0 /2-5
For multiple products use product approval form
Describe in detail the type of work to be performed: � 1'"00 / a 7 ,'jq /7 Skii e
Property Owner Information: ,�rr
Name: iJv age/ 4416/1M- - Address: 5 5 /( gh/4 . /V -
City A•/,G• A/x1 i44 State,CLZip 32233 Phone r f ; D y — 6/6 7 9 73
E -Mail or Fax # (Optional)
Contractor Information: Carlson EnterpriSes�
Company R 32216
an Name: Qualifying Agent:
B _
P y 16fsZ
Address: City State Zip
Office Phone Job Site/ Contact Number Fax #
State Certification /Registration # Ge / 3 2 9g"7�
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 ofa 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 susnded 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 hereb certify that l have read and examined this a plication 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 of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction. AVITIrMah
Signature of Owner Signature of Contracto
Name J Q�,,J �I CLNL' G� 1(�, Print Name Aria If k Car `•
Sworn to and subscribed before me Sworn to and subscribed before me
this .3 Day of (Neck. , 2010— this , Day of Arch , 20/0._
Notary blic - CH PATEI No 1 Pu
::' ARCHNA PA
} 10
MY COMMI3s MY COM # 20 E 81407 �`/ �
6r 1
EXPIRES May NA 19, 2018
( 3oe-0153 Fl orida ' EXPIRES May 19, 2018
Nb 168-0163 Flaeldalrnd om
Doc # 2012070728, OR BK 15898 Page 534, Number Pages: 1, Recorded 04/02/2012
at 10:34 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No, Tax Folio No.
State of ri_ County of O v va.
To whom Il 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:
/
Address of property being improved: �/ 6 ,% %.t 6C.* 14,4 �14,4 , ,r / ✓,
,474 gar �4 7)-7,33
General description of improvements: k efQ�
Owner V 44/ /J, / G fVG/4 "t
/
Address �O 41 C ' (/4 / : Loll l ;Z 2-31
Owner's interest in site of the improvement
Fee Simple Titleholder (if other Than owner)
Name
Address
Contractor Carlson Ent fP LLC
Address S'B 1fd Lrv�1ldbegeville Fl, 1 2216
Phone No. 0 Fax No.
Surety (if any)
Address Amount of bond S
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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY • WNER or
g N er Ae.ncy AGENT L.tt.r R.quln / m x n
Sired: �,.- �/ Date: ■ 3 5
Before me ,�•.,a - . r(!. h the * m
County of Du es y
L J • 1 G • . ., heroin by
himself/ h st! end elms that NI statements are true and accurate. i D
8
Q
Notary el Lame. Stele of � County of 1)w/ O P N
My commission expires:
Personally Mown or Produced Identification _F=427,