Permit Roof 2307 W Oceanforest 2012 L'44'.
l v �
4 's CITY OF ATLANTIC BEACH
J s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000413 Date 4/11/12
Property Address 2307 W OCEANFOREST DR
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 17725
Application desc
reroof
Owner Contractor
BALL JOHN S & MARY C SHORE ROOFING COMPANY
2307 OCEANFOREST DR W 914 7TH AVENUE SOUTH
ATLANTIC BEACH FL 322336612 JAX BEACH FL 32250
(904) 241 -8842
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 140.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 17725
Expiration Date . 10/08/12
Other Fees STATE DCA SURCHARGE 2.10
STATE DBPR SURCHARGE 2.10
Fee summary Charged Paid Credited Due
Permit Fee Total 140.00 140.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.20 4.20 .00 .00
Grand Total 144.20 144.20 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rte S
09 -
CITY OF ATLANTIC BEACH .
/ ROOFING PERMIT APPLICATION
`1
Date: I -- 1 O - - 1 -- +
Job Address: ..3O 7 0 CCct Al 'r? I ✓t.s' 1 l ),/ 1 j t
OwnerofProperty. &I/
Address: —.307 00(4 Al go ✓cs 1)y 1,1)eS1-" Telephone: Y - 638
Roof Contractor: S /i L 1 <oU / 1, U State license Number: C CC G Cy 9 /
U
Contractor's Address: 9/ 7AAA AI-t 5 4 jA-Ai L 0 37 Ls
Telephone: Rjit — 4 L/ 2 - Fax: �)f/- kS(Y 3 Emaik
Scope of Work: Iqt &,:,- /— Roofing Material 30 tr.- v /nM{�P
d e—
y
FL Product Approval # 1 / $ 6 / Valuation of Work: $ / 7 7? --,
Required Inspections: Sheathing /In Progress -Dry In / Final
If re -roof: Assessed Value of Structure: _ < $300,000/ >$300,000; Roof- towall improvements required? /1/ (1
( Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE i FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORN : 0 RE RECO ' DIN YOUR NOTICE OF COMMENCEMENT"
SI GNATURE OF OWNER: j h 4 4 / . Date: Y �/ (J a! Z i
AS TO OWNER: dr
Sworn to and subscrib- • before me this 1 �. day of 4 (1 20)� .
State of Florida, County of Duval , ►�fiY. le.
A'L�t,JOF?IE M. ADAMS ARRUp
Notary's Signature: t. Ili ! ' �_�A - , ~ NOTARY PUBLIC
❑ Personally known cam; �'ro STATE OF FLORIDA
�"`'ar'? Comm# DD0933778
produced identification � � • -�
Type of identification produced` JV 1V'C�` des 10/30/2013
SIGNATURE OF CONTRACTOR:_ Date: _ 6 Z
______X---- AS TO CONTRACTOR:
Sworn to and subscribed before me this k(. day of \ \ , 201 (il - '
State of Florida, County of Duval \ I O)\ ,.,i 01 X M -
Notary's Signature: \��
Personall known
0 Produced identification
Type of identification produced
800 Seminole Road • Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 . Fax: (904) 247 -5845
F:\roof perm a 7/2 -
niAKJ R y / M . ADAMS °+� IAFRIjY
�' N OTA R Y P
i1 ` S "E O F F LORIDA
• �`• ? Comrn# DD0933778
E • 9 Expires 10/3 0/2013
•
NOTICE OF COMMENCEMENT -
(PREPARE IN DUPLICATE)
Permit No. Tax Folio Na. t C rl �'l 3 "/ 7 d
State of - f County of IJq vr- /
To whom 0 may concern:
The undersigned hereby Informs you that Improvements will be inedible certain real property, and in
accordance with Section 713 of the Florida Statutes, the follow/Mg latermetion is stated Inthb NOTiCE OF
COMMENCEMENT. ) "
Legal description of property being Urrpmvetb 4 / 2 _ 3 7 -`). S') `1 /- 0 c 6 K ,./ i.,Ji1- /Jr '
•
Address sr properly being improved; �3 0 7 O cc cr N 5, y ts1 Or w rS t
/rte. Fit /3 c L / i 3
General dtrrrriptbn of improvements: fec 26L / _
Owner 17 1.A) /3 411
Address �" G7 0 0 (41.4 P 1 t- l) e L✓ is /
Owner's interest to sib of the improvement
Fee Simple Titleholder (If other than owner)
\ Name
c., Address
Contractor ,SA d. i t 1Q60ri.,� f r •
Adder, qty" � 11 . . E • s • J4, A,,, �, /7 ?) Lfo
` Phone No. a / " c if5r L i 1.- Fax 4 //' - ' �l�d 3 •
Surety Of any)
Address Amount of bond $ I
Phone No. Fax No. •
Name and address dam person maidng a ban for the constnrctionof improvements.
Name
Address •
Phone No. Fax No.
Name of person witidn the State of Rortda, other than himself, designated by owner upon whom notices or other
documents maybe 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
Semen 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 expiratlon • • , - Is one (1) yearfom the date of recording unless a
- different date is specified): .
• MS SPACE FOR USE ONLY k . , 1 y - h . /
P`� DATE _Vioi1t�
- - 1 al Int:Ii11i1M2ii1D in
. • , 8
sl 1 r , ' r hereto
MN/eed calms emt and d-I-- ions herein 4.
Doc # 2012079505, OR BK 15910 Page 290, 8Q mod10Op . fir; ®
Number Pages: 1
T
Recorded 04/11/2012 at 02:51 PM, li.L r JIM FULLER CLERK CIRCUIT COURT DUVAL C k .,is l(.� �t. COUNTY 8rel.���ccc
RECORDING $10.00 . _
Produced rdadllosaon '0>�f^rNT1ii�w•1141M- or
MARJORIE M. ADAMS {Jp
, k, ` ' NOTARY PUBLIC
` STATE OF FLORIDA
``�' Comm# DD0933778
c 19 Expires 10/30/2013