Permit Roof 325 4th St 2012 "' f CITY OF ATLANTIC BEACH
,.. r) 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
N. INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000418 Date 4/18/12
Property Address 325 4TH ST
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 19500
Application desc
reroof
Owner Contractor
KAPLAN,MARINA R REVOCABLE ALL SOUTH ROOFING CO INC
LIVING TRUST 271091 CONNER NELSON RD
ATLANTIC BEACH FL 32233 HILLIARD FL 32046
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 150.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 19500
Expiration Date . 10/15/12
Other Fees STATE DCA SURCHARGE 2.25
STATE DBPR SURCHARGE 2.25
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.50 4.50 .00 .00
Grand Total 154.50 154.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
04/12/2012 13:07 FAX 904 262 1887 LAWRENCE MUR INC Ij003
rir ,--,-;-, 7 . CITY OF ATLANTIC BEACH 09 W I I •
•, !
1 ' ) OS SEMINOLE ROAD, ATLANTIC BEAM, Fl 32233
j i � OFFICE: (904)247 -5826 • FAX NO,:(904)247-3845
r�, ..a xr :;• BUILDING- DEPT�COAa.US
'" BUILDING PERMIT APPLICATION DUVAL COUNTY
1 A m A M R E 8 & R v A L t ON aF WOR1� 8 C L FT. U h D E R ' R 6 a F l ••-
3�5 4 . ST T tITIAit c_ g rc _ -t Fl— 3t1 33 ) 1 ,S"0 a cr.,
4. LEGAL DESCRIPTIOrit ' ' ' ' .• OINEIS OF WORK • ' . O. .- :. USE. •, Crum '
0 NEW WILDING ❑ osmoLITION 'P - ESIDENTIAL
LOT PLOC( SUB DIVISION ❑ ADDITION 11 CONVERTING USE D COMMERCIAL
7.. DESCRIPTION OF WORK ' DG ❑ALTERATION ❑ ACCFSSORV BL 8 FIRESPRtl1W R°
C7 REPAIR 0 POOL 1 SPA Cl YES D N/A
P L -r.-N.' 0 V e om D N
D��ppv •
CON'IRA 4R: ARCH i ERGIREER:. .
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9. NAME MAP.iMR A W I - 'L T 4 5. /�� NAME / J 23. COMPANY NAME
r)- 2i r•ra f2 (W-P -J 4 _
, - 1$, NAME ]� �� /� 24, LICENSEE NAME
/
111 ADDRESS: 17. STATE OF FLORIDA LICENSE NO.: 23, STATE OF FLORIDA LICENSE Na:
«74 ;NI ;;,:r - -3C 0 te• � C e 1 32 d4 / . ,
— 18. ADDRES 28. ADDRESS:
12- 4.4 e– - r ‘ -e--- i ‘ 3�► a S lab R C
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11. OFFICE PHONE 12 FAX NO.: 1 9, OFFICE PHONE 20. FAX NO.; 27. OFFICE PHONE: 28, FAX NO.;
13, CELL PHONE; j V� �a3 21. C PHONE 7 29. CELL PHONE;
7!
14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS:
I: r. ,NEE'.Sai1PL.F <Tt1:E:1lOLPF • ;, ' , '. SONDwK' CQMPANY: ilaitidisi I • LfRe
M. NAME 32. NAME 35. NAME:
N ip
32. ADDRESS: 34. ADDRESS; 38. 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 worts will be performed to meet the standards of all laws regulating constructlon in this
jurisdiction. This permit becomes null and void if work is not commenced within sbr (6) months, or if construction or work Is suspended or
abandoned for a period of six (6) months at any time after work is commenced. l understand that separate permits must be secured for
Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bolters, Heaters, Tanks, Atr Conditioners, etc.
OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning- I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law.
*** WARNING TO OWNER: ***
YOUR FAILURE TO RECORD A 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 THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
O RiER or AGENT CT _
.I
cif AgxR r r e[Aeortwhcr AgivicY'Letar l e/rims).
Signed: �1.t�1n Kv 1 t _ oete. Lr' I L 12 son i��� - � .:.�_ :" Doe: 1 f 1,?P l Z
Before me this La-, day of - t 1 - - 2p In the county or Before - this 1 day of s / , 2009 n the county of
F
Boyar State of Piertdor, has personally appeared Duval, Stale of Florida, has pa : • appeared
t rvi_512V t
hedn by himself / hersef and affirms that al statements and declarations are nano by himself / herself and affirms Mat all statements and declarations are
true and accurate. ��yy true and accurate. 7
Notary Public at Large, State of �l , County of t. Y t. . Notary Public at Large. State of ii--- , County of f
0
' Produced I. , ■ - , • I ri� , . ti ' - 1 Ll c_L r \Y` ❑ f Pr6tlucea K ��A 1
Notary Signature: 14 _ 4� No tary S ign - � Sb� I /�rs >..�
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COMMONWEALTH OF PENNSYLVANIA ! s � e; , ; , y ,
NOTARIAL SEAL =a " LuarM
1. * a ; *_ EXPI r,;tY CI RES: ., ',: Febr SIGN G4 OG 14 9 , 57 014 760
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ANA E. VIVERO -NOTARY PUBLIC
• �♦� fiAlfyA 2
,z = ' °� = n, ;:"`� Bonded Thru Notary Public Underwriters
Rpm POMO Applksuurt inz REVISED: 1211 �I Marlboro Twp., Chester County
MY COMMISSION EXPIRES OCT. 20, 2014
Doc # 2012084624, OR BK 15916 Page 991, Number Pages: 1, Recorded 04/18/2012
at 02:04 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
04/12/2012 13:07 FAX 904 262 1887 LAWRENCE OR INC gD002
NOTICE OF COMMENCEMENT
BARE IN OuPLICATTi)
Pewit N. Tax Folio No.
State of ,(70.1e4d)n CoIxUy a1 aI ea
To whom It may concern:
The undersigned hereby Informs you that Improvements wits be made to certain real property, and In
aeoorelettoe with Section 713 of the Flottda Statutes, the forming Information to stated in this wOTICI OR
cOMMENCiAU(T.
!r Leon desollpMoo of property being improved: • • • r . • I a • • _ ; ' o
I' E.
S bD1VIS1 " 'TLi ire "i f� .• v •. . • , OLRTTtte - . • IN
_91-kr 6 °A6efo9 pc Me cup -ieM P rr zu'6 0p D vAl. )M s f 1.01,24] a
Adam= of property being Improved: . r le 4 5 , I ..... .2 -
General description of Ynprovemants: ,✓..12, Rear
+ Rays !ug
Ir owner k � , .T.- ti 6 : , v: I . • + . �:-
E
Address DV -T t•'••1._ L„ . L , - r U:, /t 7
owners Intro* in site of the improvement r r _ 42 4
Fee Shpts Titleholder (If other then owner)
Namur
Address Kl �,/� c
er y
Cof or f —Cc v R� 6/iY6• c o -
Adana et' .P.01.eivoN/5 ‹, ei /// �L 3 2?X /
0 1 . Phone N o. 90g 7,c' /- . 34 3 Fax No.
r Dusty (V ony)
Address / /f Amount a bond S
Phone No �� F
Name and eddies. of any person making a loan for the the Improvements.
Naine
Address
Phone No '' • .
Nona of person within the Bast. of Florida. other than /r den by owner upon whom notices or ether
doambnts may be saved:
Name _
Address \
Phone No. Fax No. . �y
In addition to himself. owner designates the int w re person • Ai . e copy of the LIsnor's NOW es provided in U
a ion 713.06 (2) (b). Florida BtaUt.e. (FYI In et Owner's • .
c )
Nam r ,..;.„..0.4'.4._...,-
:::t d..
Address ,
Phone No. Fox No / 11
EYptatlon data of Notice o( Commenosmaa (the expiration dote of Yew tom 1hs d of 110ording unless • : '' .
different dale is .p.ctfsd): / :'
Tula WACt '$ USN ONLY OM ER
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resew e frrr .
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rsue meawswe ew COMMONWEALTH CI
M' °1 w Ord ia° NOTARIAL SEA L
• e "2iit ANA E. VIVERO - NOTARYPUBLIC
14. - East Marlboro Twp., Chester County
l'eg .Shea d d S vu � � M)+ COMMISSION EXPIRES OCT 20, 2014
Nymni.wgn : /1[ 4
N.r.orwlhr Kr•.rn 1 a
•rase.