1990 Mipaula Ct roof 2012 CITY OF ATLANTIC BEACH
s7 800 SEMINOLE ROAD
"j ATLANTIC BEACH, FL 32233
` INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000762 Date 6/19/12
Property Address . . . . . . 1990 MIPAULA CT
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9500
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Application desc
reroof
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Owner Contractor
-
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BURDETTE THOMAS R IV & AMY J D. S . KILLIAN ROOFING &GC (ROOF
1990 MIPAULA CT 3948 3RD ST S BOX 122
ATLANTIC BEACH FL 322334555 JAX BEACH FL 32250
(904) 509-8470
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 9500
Expiration Date . . 12/16/12
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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 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 104 . 00 104 . 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: 990 �lJ�j�Z& 3T Permit Number:
Legal Description Parcel#
Floor Area of 9q.Ft. q.
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooUspa window/door
Use of exijting/pro
(circle one): Commercial Residents
If an existing structure,is a fir sprinkler system installed?(Circle one): Yes (� N/A
Florida Product Approval# - P —
For multiple products use product approval form
Describe in detail the type of work to be performed: Ae� DGt_:11
X& &1_101W ty Z 4---,06' 1� eel�l
Property Owner Information: oe
Name::Z� Q-s i6ty/ e e Address: 9Y O /. - G;�—
City Rr • State,• ip3zZ3? Phone fa Z
E-Mail or Fax#(Optional)
Contractor Information: f! y
Company ame• � Fl 7��rL Oualifyi ent: _ a4T
Address: City JT Stated Zil �
Office one Job giiel Contact Number ,r Fax# � � �j tf
State Certification/Registration# L G I
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
.I pplication 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 o o 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 work is not commenced within six(6)months,or ifconstruction or work is suspended or abandoned for aperiod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical'Work,Plumbing,Slgns, Wells, Pools, Furnaces,Bolters,Healers,
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 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
npe of work will be complied with whethersppeci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local Imv regulating cons uction or the performance of construction.
Signature of Owner Signature of Contracto
Ap
Print Name G« {� /�e�L /J Print Name
'L...................................................................................................................... .............................. ...
...................................................... ....................................
� A<
Sworn W and subscribed before me Swoyh t and su scribed ore
this Day of d .20 /.2 'thi ay o 20
fury Public ROSAT. � u sc
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j EscpNea Aplil 2D,2016
enatenwt,�retiertaeoetooaesrote ?� ?; SHIRLEY L.GRAHAM
MY GOMr,41SSI0N#p(
EX 1. Feb957760014
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rylic Underwriters
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
To who ay 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:
Addr of property bei proved: IF
r
General description of improvements: fGGr c'
Owner
Address , t^ r �?
Owner's interest in site of the improvement
Fee Simple Titleholder 4#other than owner)
J Name
Address
I t
Contracor
III ,. .
Address j' )
Phone No.804 246 7663 4 Fox No.
Sure if an
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
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 play be served:
Name N." r(j
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.(Fill in at Owner's option).
Name—
—r' V 4
Address / '
11
Phone No. Fax No.
Expiration date of Notice of Commencement(r x irati ate one( year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLYWNE
no r _
21 TE
Galore
Me this da Y or In
CQ_ypfY of Duval, la Fbrida,h s perjp 1 app
7 0/✓IeL�C ��d i H ,( Herein by
himsam herself and atoms that all statements and docler
aro true and accurate t ROSH T.SANTIAGO
careliwimil#EE IBM
Doc#2012125311,OR 8K 15911 Page 1615, � �
Number Pages: 1 1, ,
Recorded 06,1912012 at 08:48 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL RWAry Public at Large, ete County or
COUNTY Pa� n er euy Knowli or
RECORDING$10.00 Producedldantl6catlon
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