1745 Beach Ave Roof 2012 1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
N� ATLANTIC BEACH,FL 32233
J ..
��. ,. INSPECTION PHONE LINE 247-5814
12-00000761 Date 6/18/12
Application Number 1745 BEACH AVE
Property Address . . • • • •
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4385
-------------------------------
Application desc
reroof
---------------------------------
Owner Contractor
----------
------------------------ BOHEMIA CO, INC (ROOFING)
--------------
EAKIN, PAUL
1745 BEACH AVENUE 3950 ST ISABEL DR E
ATLANTIC BEACH FL 32233 JACKSONVILLE
E FL 32277
539
-- -------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee 75 . 00 .
Valuation . . . . 4385
Issue Date . . . .
Expiration Date . . 12/15/12
-------------------------------------------- ------
____ _ _ ----------------- ---------
Other Fees
. STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
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
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address 1745 BEACH AVE.,ATLANTIC BEACH,FL 32233 Permit Number:
15-10 09-2S-29E N ATLANTIC BEACH UNIT NO 1 PT LOT 30 Parcel# 169670-0000
Legal Description oor rea o q. t. t
z Pro osed Work heated/cooled non-heated/cooled
Valuation of Work$ ✓ p
Class of Work(circle one): New Addition Alteration Repair molition pool/spa window/door
Use of existinglpropused structure(s)(circle one): C i Circrcile ones^ s--moo N/A
If an existing structure,is a fire sprinkler system installed?
Florida Product Approval# FL10124.16
For multiple products use pro uct approva orm
COMPLETE RE-ROOF, REPLACE ENT WITH
Describe in detail the type of work to be perfonn�d,:� 4
SHINGLE
Property Owner information:
EAKIN PAUL M Address:1745 BEACH AVE
Name:
City ATLANTIC BEACH,FL State—Zip 32233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
BOHEMIA ROOFING CO.,INC. Qualifying Agent: IVANA HODULOVA
Company Name' Cit JACKSONVILLE State FL Zip 32277
Address:3950 ST ISABEL DRE 904 gg2-2114 Fax# 904-353-2700
Office Phone 904-659.3539 Job Site/Contact Number 9___21.1.__
State Certification/Registration#CCC1328454
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
kor
llation has
Application is hereby and that all work will be performed t meet the standardssoJ all laws r•egulatrnconstruction ed Icertify-that Y n this jurisdict on. This permit becomesrior rn the
issuance i f a permit a p /
and
void
lmrnek is nced of commenced understa understand sepithin arate permits must beconsecured./or Electrical Work,Plumbing.Signs,
sr,aW¢lls,Pools,FdinaeessBoil Bat any oilers,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 ATTO NEY BE ORE RECORDING YOUR NOTICE OF
Hype qJ work w7(be have read
co i d with whc[her tpecieted herein olication n ikto Thecg some
of a permit e true and
doesct. All not presumertoxgive auhr raws and di i,I re or cancel thisthe
provisions of any other.. er state,or c !law regul�mgonw caction or the perfw7nance of cnrtstruction.
Owner Signature of Contractor
Signature of O /D�141 G
Print Name �!�( fr [.
Print Name .��u.l....._M...,......... k.1.D................................... ......................._. _.
Sworn to and subscribed before me Sworn to and subscribed before me 201
this _Day of V 20_12— this 12!�;L Day of
r�M[ �. �c - rxr
otary u c
Notary Public Revised 01.26.10
PATRICIA JACKSON
MY COMMISSION#EE 064342 „ ' --
,r ,i�+"•nib, PATRICIA JACKSON
EXPIRES:June 14,2015 ?*c *: W COMMISSION#EE 064342
Balled Thru Notary Pubo ftleiwr*^; ;'?> EXPIRES.June 14,2015
Balled Thru Notary Pubk Undarw brs
Doc#20121 24555,OR 3K 15971 Page 704,
Number Pages: 1
Recorded 061812012 at 03:10 PM,
NOTICE OF COMMENCEMENT JW FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
Permit No.
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
1.D0SCrlptlOn Of property(legal 11CRE#169670-0000 LEGAL:15-10 09-2S-29E N ATLANTIC BEACH UNIT NO 1 PT LOT 30
a)Street(job)Address:description):
B ACH AVE,ATLANTIC BEACH,FL 32233
COMPLETE RE-ROOF,REPLACEMENT WITH SHINGLE
2.General description Of improvement..
3.Owner Information EAKIN PAUL M 1745 BEACH AVE,ATLANTIC BEACH, FL 32233
a)Name and address:
b)Name and address of fee simple titleholder(if other than owner)
c)Interest in property OWNER(S)
' 4.Contractor Information BOHEMIA ROOFING CO.,INC. 3950 ST.ISABEL DR E,JACKSONVILLE,FL 32277 CCC1328464
a)Name and address: Fax No.(Opt.) 904-353-2700
b)Telephone No.: 904-859-3539
5.Surety Information
a)Name and address:
b)Amount of Bond: Fax No.(Opt.) -
c)Telephone No.: —
6.Lender
a)Name and address: Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address: Fax No. (Opt.)
b)Telephone No.:
8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes:
a)Name and address: Fax No.(Opt.)
b)Telephone No.:
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATIONSECTION 713.1 O OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, ART I, ,
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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OMMENCEMENT.
STATE OF FLORIPAYWA40(SON 10.
�---
COUNTY OF NNE a
1i1YC011►IISSION i EE 05M Signal ira of(honer o wner's Au orized Officer/Director/Partner/Manager
EXPIRES:,lutuet4,20 Paul M. Eakin
'wfjt• Print Name
20
The foregoing instrument was acknowledged before me this day of =..?,- , by
as (type of authority,e.g.officer,trustee,
attorney in fact)for (name of party on behalf of whom instrument was executed).
Personally Known�l OR Produced Identification Notary Signature
Name(print) y:.�
Type of Identification Produced OR
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
r•0RMSM0C,rvsd2010 Signature of Natural Person Signing(in line 4 10.)Above