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Permit Roof 805 Amberjack 2012 :cl �`I f CITY OF ATLANTIC BEACH r r) 800 SEMINOLE ROAD J, ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Ji Application Number 12- 00000382 Date 4/05/12 Property Address 805 AMBERJACK LN Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 7208 Application desc reroof shingles and torch down Owner Contractor TESTER WILLIAM J QUALITY DISCOUNT ROOFING LIC 805 AMBERJACK LN 1794 ROGERO ROAD ATLANTIC BEACH FL 322334224 JACKSONVILLE FL 32.11 Permit ROOF PERMIT Additional desc . REROOF SINGLES AND TORCHDOWN Permit Fee . . . 90.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 7208 Expiration Date . 10/02/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.40 Fee summary Charged Paid Credited Due Permit Fee Total 90.00 90.00 .00 .04 Plan Check Total .00 .00 .00 .04 Other Fee Total 4.00 4.00 .00 .04 Grand Total 94.00 94.00 .00 .04 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: SC Arnfrzijcicr Ln. ATI (F3ch 22:33 Permit Number: Legal Description 2 0-(on t 35- -aqc rap ( peil mS -4 Parcel # 1111 ,- b000 Floor Area o q . Sq. t Valuation of Work $ � ?.0 °O ' Proposed Work heated /cooled 1 al a non - heated /cooled i q 9S r2� 12001e- Class of Work (circle one): New Addition - Alteratio - Repair Move Demolition pool/spa window /door Use of existing /proposed structures) (circle one): Commercial esidential �Z 4 1112 'K P � , '^ I^ If an existing structure, is a fire sprinkler system installed? (Circle one): es o %9:` 1 Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: L u » _ e ' t to i : 41 -g ' • , • a A s Property Owner Information: Name:A") t � t t rA Address: 1 Pir :C'- . City It Y ► t` ( (>< e4 GY1 State ELZip 32250 Phone ciO`-1 - 1 o — I ip7 S E -Mai_ or Fax # (Optional) Contractor Information: rr Company Name:r ,t a L O∎cil � , J\ (eod f1g L1 0. Qualifying Agent: h U a, Z-p� . e ,0, Address:111 g ('c P rte Cit State L Zip "" 2 ( 1 _ Office Phone °( 0-1 - y (a Soo© Job Site/ Contact Number `y i qov `x(09 i0ZI L0 Fax # $l .329 -(a(ocia State Certification/Registration #C1( I 3 Z 9 :� Architect Name & Phone # ,i /X Engineer's Name & Phone # A//' Fee Simple Title Holder Name and Address /U e KJ� Bonding Company Name and Address n)pyk.) Q _ Mortgage Lender Name and Address Law tiik) io 1 6 , X Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 aperiod 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, 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 YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that I have read and examined thisplication 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. Signature of Owner ;Vlr: Signature of Contractor Print Name j 1' i iv) S -{- Print Name RC^,C,�, Sworn to and subscribed before me Sworn o and subscribed before me this S Day of Arp� 2 t , 201. thi (4 Day of t . ri 1 , 2012 1 1 . 4 . Nota lic j ? ow ° «ic : SHEREE J. AMATO ' ��`�" Pu; ' ry 4 r , 'i .1y Notary Public - State of Florid/ 1 ,��. Notary Publi. tate of Florida .�=` « o;; My Comm. Expires May 1, 2011 t; ih4 « r° My Comm. Expires May 1, 2015 Revised 01.26.10 ' sks Commission # EE 89125 � ' o��0 Commission # EE 89125 • CO y n oo9t a b b 4 b ro a d n x (4 o a V o o -. cro C' o • 5 - a. ' E. C ri 14 o a C. o '" o ' a = . a cr N O.4 o o' a __ o .• cr C. P = o P (IQ le ss cs w Q. O O t< " 'rs y OCe . 0 CD `' p O C < 00 U' 0 O O o O (j\ a a- ,- C4 co a Fi> LA i. a.W y T Q O Az '°. o Cam" o : cr0 P r �; cr ^ O .I a' -.. c a n e..1 "° o -i x a v im , 0 O n • tt CA d O 4.... N -. 'o `� x t.il 1 P F1, n • E ° o A o P N r c o b - AZ p :� o' n 4t s C 5. a ,t: o n 0-o x r, a P s n am " 4t CM 8 cn d cp CD o c less.,.. 0 7 n n • 01 vi W N p �p oo J 9' Cn w N .— p �p oo �1 5;" vi w N .- b A N o o n r ! o o o 4 a o > O O v1 n 4 c n 5 o o O • fl, o �' a °� .8 5 5 5 Z ( • g 5- 5 v) t : cj rs cu uc .� vc ao vc o va • o. n a co va °o v, • C" e CD 0 o ac O co n i P O 1 c. ° a c n P C <, p O 1 N 0 o CA fit cii P e N l i i , 0 A in ►r 4t �� . N . . . . . °1 Cn W N O y �1 O� tli W N x R .1 a' ''� p c4 d A , 5 4 O ° y 42:1 p 7cJ n to Y C © O C, r• f-• ∎ 0 0 .. r- O cn Q p n 'C3• ° ; O �] U, N Ito ° co y n g a' o z IQ co 8 .+ too o 0 4 to A K C A "! b O R . C n CI co y A R O O g to a. 0 O O GA A Vi AD ..r 0 n Ao 4t 0 0 ac 0 I `' a Z ora 0 y 0 — o 0 0• c ° O `n CO `° r" C� ° ) w C y id CD 0 n c 0 0 b e s N. o y o c co .. '0 4 cn o 4 ` `< p o = R ( � r d o- � ¢ co to p r' , ..% • ..1. cr co PI 0 0 ■ CO CD *CS 0 rri ' o 5 c o co Po o rn elD et ,i a c� al., I. n o co to \ Q., 0 c� — a c g 1 PI eD � " �' P3 C ■ o -, qb n 4t Z. ; • CD � a.o o C " 4 c_.\\ Q. o o 77 cn r� o cn NOTICE Number OF COMMENCEMENT Doc # 201 Pag20es: 745Q 1 4 OR BK 15903 Page 836, Recorded 04105/ J 2012 at 01.22 PM, IM FULLER CLERK CIRCUIT COURT DUVAL Permit No. _ COUNTY Tax Folio No. ' O RECORDING $10 THE UNDERSIGNED hereby gives notice that improvements will be made to certain real ro er ty, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. P p 1 .Description of property (legal description): , , a) Street (job) Address: : I. • 2.General description of improvements: _ • 1 ' + • 3.0wner Information a) Name and address: A b) Name and address of fee situp e titleholder (if other than owner) c) Interest in property r • - ; 4.Contractor Information „3\ a) Name and address: b) Telephone No.: . - t * Fax No. L I • P ; . 5.Surety Information ' • - L 3 2,2_0 (Opt.) - _ a) Name and address: 4 _ b) Amount of Bond: c) Telephone No.: ti.Lender Fax No. (Opt.) a) Name and address: Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: x 8.In addition to himself, owner designates the following person to receive a c py�of the (Opt.) Noti as provided in Section 713.13(1)(6), Florida Statutes: a) Name and address: 7'✓0 b) Telephone No.: 9.Expiration date of Notice of Commencement ( the a xpiration date is Fax No. (Opt.) is specified): one year from the date of recording unless a different date 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORT{ OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA ♦ — — �— .t► — COUNTY OFPINELI.AA � " uu „ �� I O �,.pV A � , A ''' �i SHEREE J. AMATO O ' ` � - Notary Public -Stat Florida (( ' • ; 4,37 e O Signature of Owner or Owne 's Authorized Officer/Director/Partner/Manager : { My Crnnm. Expires May 1, 2015 / �- LI J Ten g ...? >>' Cc : mission # EE 89125 ✓ Print Name The foregoing instrument was acknowledged before me this y 1) day of /t- 7), > 20 ! L.. _ b as (type of authority, e.g. officer, trustee, attorney in fact) for (name of party o , behalf of whom instrument was executed). Personally Known OR Produced Identification Notary Signature NIP • • I � � �- i � / 1 tt1 lliIJ Type of Identification Produced , �, . `� 1 `Ln Yl c, ,�. Name (print) OR Verification pursuant to Section 92.525, Florida Statutes. U the facts stated in it are true to the best of my knowledge and belie f aloes of perjury, I declare that I have read the foregoing and that FORMS/NOC, , ,,2010 Signature o antral Person igning (in line # 10.) Above