Permit Roof 2331 Seminole 2012 CITY OF ATLANTIC BEACH
R �
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000671
Property Address . . . Date 5/31/12
2331 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4500
Application desc
REPLACE ROOF
-----------------------------
Owner Contractor
------------------------ ------------------------
HARRISON, KEVIN GREAT WHITE CONSTRUCTION INC
2331 SEMINOLE RD 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
--- Structure Information 000 000 REROOF
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Permit ROOF PERMIT
Additional desc REROOF
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date Valuation 4500
Expiration Date . . 11/27/12
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Special Notes and Comments
NEED RECORDED NOC PRIOR TO 1ST INSPECT
------------------------- ----
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
-------------------------
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Fee summary Charged Paid Credited Due
------ ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CI'T'Y OF ATLAN'T'IC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: .2331 inricr,t�r �� l t pL- X3333 Permit Number:
Legal Description a parcel#
Valuation of Work$ yS� 1~loor Area o t.
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New AdditionA Brat' n Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)((circle one): Commercial Residential
If an existing structure,is a fire sprinter system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed:
Property Owner Information•
Name:_ VievJt f\ C-501 iA
City H-t1 �cJh Address: a3�il �; m�nv_ 1 _�} n EC 3a033
State V_zip ?z phone 5o(G
E-Mail or Fax#(Optional) -
Contractor Information:
Company Name:_ Gscck t-�n� C-a `,Ckt1c {nu.
Qualifying Agent:
Address:�43�� �r ����5
�a� Y`c.
Office Phone oY cg_3._I�s Job Site/Contact Number rG,,City_,=>8, Zip 3Zz
State Certification/Registration# i 3 Z�t>a,7 Fax State
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 obtairx a permit to do the work and installations as indicated. 1 cert fy 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 rttr((
and void if work is riot commenced within six(6)months, or if construction or work is,
or abandoned for apertod of six(6)months at env time after
work is commenced. I understand that separate permits must be secured for Plectrical Work,Pluenbdng,Signs, M'ells, Pools, Furnaces, Boilers, ffeaiers,
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.
I hereb cer tifv that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing!Iris
g pe olYwork'will be complied with whether speci ted herein or not. The granting of a permit does not presumejorve a ority to violate or cancel the
provisions of any other federa state, or local law regulating construction or the performance of construction.
Signature of Owner '` G
Signature of Contractor
Print Name Kms; «-
1x wcrro.� � Gt��,
................ Print Name
wY'
Sworn to and subscribed before me ...... �� ....."""""".."""..""
this 3t Day of nn c 1 20 I Swor€�Arrd subscribed bene
this Day of 20 ,
Notary Public �otaaY P44,o �� p ,�
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* * EXPIRES;January 22,2016 � � MY COMMISSION#EE 057349
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J1 Clic ed FROM:
TO:92475e45 P:1/1
Kermit No. NOTICE 0.14- COMMENCEMENT
State of Florida, County of Duval Tax Folio No.
THE UNDERSIGNED he
.rcby give notice that the improvement will be made to certain;real ro
Chapter 713, Florida Statutes, the following inTorTnation is provided in this Nance of Commencement,
in accordance with
I. Description of property(legal description ofproperty
s and address if available):
31- 1 3`t --
Z. General Descri tion of improvements: t
3. Owner Information:
a.) Name and Address: ncr� 1 �K
b) Interest in property:
c)Name and address of simple titleholder(if other than owner):
4. Contractor Information:
a)Name and Address:
b) Phone Number:
5. Surety Information:
a)Name and Address:
b)Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
b) Phone Number: _.
7. Pcrson within the State of Florida designated by owner upon whom notices or other documents ma be served a
provided by 713.13 (1)(a) 7, Florida Statutes: y s ed as
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to hirnself/hirself, Owner designates
a copy of the Lienor's Notice as provided in Section 713.13(1) (b),Florida Statutes.ot to receive
a)Name and Address:
b).Phone Number of personnr entity designated by owner-
9 Expiration date of Notice of Commencement (The expiration date is one(1.)year from the date of Recording unless a
diffcrcnt date is specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE, FXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED J.MPROPER PAYMENTS UNDI-,R CHAPTER 713, PARI'
1, 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 WITH YOUR LENDFR OR AN ATTORNEY 13E ORE COMMENCING WORK O.R. RECORDING
YOUR NOTICE; OF COMMENCEMENT.
The pl (voing i.nst ent was owlcdged before me this . �day of wp
� f
�S�l11�9�*Ilp�ludq �'v�0�rr. U•
810Z'Ed�ena�P;;,;::sx�
NOTARY PUBLIC, STATF.OF FLORIDA