Permit Roof 162 S Oceanwalk Dr 2012 r CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J $ INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000414 Date 4/11/12
Property Address 162 S OCEANWALK DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 14000
Application desc
REROOF
Owner Contractor
DOBBINS MARY E DS KILLIAN ROOFING
162 OCEANWALK DR S 3898 DUPONT CIRCLE
ATLANTIC BEACH FL 322334678 JACKSONVILLE FL 32254
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 120.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 14000
Expiration Date . 10/08/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 120.00 120.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 124.00 124.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of
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 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
Address { property being improved: 1 4t..- C .� ( i,.) i Y. - e ,
General description of improvements: Re roof
Owner - b )l (4 R� c - .h r a it } r
Address J i 0.-G. IA/ al S (1, f /h. t-t f g-�
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor DS Killian Roofing & General Contractors Inc.
Address3948 S. Third st Suite 122 Jacksonville Beach F1 32250
Phone No. 904 246 7663 Fax No. 339 9233
Surety (if any) N/A
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 N/A
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 N/A
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 11 OWNER
Signed: U1L11 � 8 �4 XyLJ 1 DATE A i )l d 1 /a
Before me this !G rrl day of AI ). 11 in the
County of Duval, Sate of Florida, Has personally appeared
M 4,i,•
4,),A e l f
� Y'1 r . herein b
himself) hers and and affirms that all statements and ` $ � * . , BRITTANY PLUMMER
;.
are true and accurate
Doc # 2012080605, OR BK 15911 Page 945, ,�"
: /.. :.� Commission # EE 142834
ar bee Number Pages: 1 �- Expires March 21, 2015
Recorded 0412/2012 at 03:13 PM, • Bonded rnTay Fan lnaremeata3�70ts
JIM FULLER CLERK CIRCUIT COURT DUVAL
Notary Public at L , State of 'L . ° -. I t County of _._
COUNTY My commission expires: (, 1 7 S `
RECORDING $10.00 Personally Known or
Produced Identification )./c lc/ 8." )'; (. ..+�.
t.
41
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: /6, C Ctet-tki 12J al 11 4E s 4 // ich 3 � ,'.) 3 - Permit Number:
Legal Description Parcel
Floor Area of Sq.Ft. OpAx Sq.Ft
'o of Work $ / Proposed Work heated /cooled UU non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fir rinkler syste installed? (Circle one): Yes No N /A
Florida Product Approval # -r6. ' ��4
For multiple products use product approve fo
Describe in detail the type of work to be performed: le /Oar
Property Owner Information:
Name: -� A P ,--001h .A,s, Address: // 10 d ...,4-4) /,f7 i/L OIL S
Cit State 1:4 Zip Phone 9►.0,>< - //,, , , g
E -Mail or Fax # (Optional) 1L.,p `01 & A 44 w Jl ,t.4.. r
Contractor Information:
Company / at N e: ` /� �ar - • Qualifyin ent: —P c--1e ? ( l ( 3
i i City tL Zip 3
Address: ����t��: h' State
Office Phone ��',4�111/ mil Job Site/ Contact Number 57 �`/ 70 Fax #
State Certification/Registration # Z CG / Ai '24O 3
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 ermit
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 o six (6)
months at any time er work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, We , 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 1 have read and examined this application and know the same to be true and correct. All provisions of law and ordinances
governing this type of work will be complied with whether specified herein or not. The granting of a permit does not pres e to gi • % thority to violate
or cancel provisions of any other federal, state, or local - law regulating construction or the performance of construe' •
O
Signature of Owner e Signature of Contractor
Print Name , o os Print Name p 0._ ...— j
. / 1-.,77((eil
Rwnrn to and cnhserihed before me Swo and subscribetl]beforemo A f_) .