Permit Roof 73 Garden Ct 2012 CITY OF ATLANTIC BEACH
N is.
800 SEMINOLE ROAD
J , '" ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000478 Date 4/24/12
Property Address 73 GARDEN CT
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 7000
Application desc
REROOF
Owner Contractor
SMITH FRANKLYN C & BETH P DS KILLIAN ROOFING
73 GARDEN COURT 3898 DUPONT CIRCLE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32254
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 85.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 7000
Expiration Date . 10/21/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 85.00 85.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 89.00 89.00 .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: 1 23 1) ‘GY/r F Permit Number:
Legal Description Parcel #
Floor Area of Sq.F't. F •t -- 3 Valuation of Work $ ,K, Proposed Work heated/cooled o n- heated/cooled
Class of Work (circle one): New Addition Alteration : R Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a f springy e stem installed? (Circle one): Yes No N /A
Florida Product Approval # 6 fr
For multiple products use product approval form
Describe in detail the type of work to be performed: k ------ XCO / -
Property Owner Information:
Name: 4► -3 / 7 v ! Address: / j? 6-ee,.-r :r
City State Zip Phone /Jq__ ?__4 3
E -Mail or Fax # (Optional)
Contractor Information:
Company Name DS Killian Roof & General Contractors Inc. Qualifying Agent: David Scott Killian
Address: 3948 South Third St Suite 122 City Jacksonville Beach State Fl Zip: 32250
Office Phone 904 246 7663 Job Site/ Contact Number 904 509 8470 Fax # 904 339 9233
State Certification/Registration #: CGC 1504656 CCC 1328203
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. 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 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, 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 plication and know the same to be true and correct. All provisions of laws a
type of work will be complied wit whether ci�d herein or not. he granting o a presume f dinances governing ae this
provisions o a other federal, sty '•, r f permit does not resume to .0 to violate or cancel the
P / any f / or local law regulatin • construction or the performance of construction.
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Signature of Owner ��. , _ Signature of Contra o/
Print Name 4 e 4� Ss
n (37/ Print Name
Swor I i su . ,, a - o .rat
ii �y� • AMANDA WHI Sworn to and subscribed before me
this
� r` Irf �'�`7 EXPIRES 21, 2015 / 20
. o t. Underwri r fit` .k.:.% SHIRLEY SHIRLEYI. GPA HI" AI_ -1
Notary Public ,
Notary Pu , : i o= EXPIRES Feb l. are i :(,
or d ` • Bonded Taru Nct-o,, P
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OZ ST 32 <Z--3 s 3030
Doc # 2012087712, OR BK 15920 Page 813, Number Pages: 1, Recorded 04/23/2012
at 08:36 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
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: ! _5 " ' l. 3 D9 _ 5 _ cj u5,03
L i'" f 11f41,.1- t c 6 k 4 L., ct A/o_ 3
p r5 2 yf } , 7.5 7L. R��p e 5ct - - / 7 19
Address of property being improved: 1 3 t r.- ft ft/ C. L /ZT
At c1.1{ - ,f 1, F � . LL33
General description of improvements: Re roof
Owner Fi t,i ( 1 ;1 '/1� /AN r P. 5
- 1 T'f>'
Address 7 3 j r kit 'rj LG c• • X7 l ! >• f fri ..,1-, ..,1-, j ' c c re c L F
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Owner's interest in site of the improvement 1110 n w r‘
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor DS Killian Roofing & General Contractors Inc.
Address 3948 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. (Fit in at Owner's option).
es N
Name N/A < 3 N N
Address r e
Phone No. Fax No. v w
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Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a t ,Y W o
different date is specified): ` , E w
THIS SPACE FOR RECORDER'S USE ONLY OWN • t E
Signed. ,I, L 1/ , DATE y_ z�_ / Z a U s.
Before • • this_:-- day o - • - 1 .. in the Z a
Count •f Duv I, State of Florida. has •ersonally appeared on: ,,,,
f' .'7 i ' Ld y \ '' Lu 11 '� herein by ��•` ►p,
himself/ herself and affirms that all statements and declarations herein s ``S �b%
are true and accurate '. fl y 1 4' 4.4 41
n it,e/ s t• - On- , Oh, e A cili,t, ,....__..
Notary Public a arge, State of _. County of �•'
My commission xpires ! 1 y . ! -,
Personally Knbwn or
Produced Identification % / .,:r a '/\.• t i % r, i 1 , \ c.t' `i. r' r `.