Permit Roof 152 3rd St 2012 �S r4 1„
N
„' CITY OF ATLANTIC BEACH
'' .. 800 SEMINOLE ROAD
4
�� ,.., � ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000924 Date 7
Property Address 152 3RD ST /20/12
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 3500
Application desc
reroof
Owner Contractor
ANDO STEPHANIE ELIZABETH A CROWN ROOFING INC
152 3RD ST 2159 ST JOHN'S BLUFF RD S
ATLANTIC BEACH FL 322335209 JACKSONVILLE
FL 32246
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 70.00 Plan Check Fee .00
Issue Date Valuation 3500
Expiration Date . . 1/16/13
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 70.00 70.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 74.00 74.00 .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: /re 3 'Id S'T �
'�*`"' � �� lPermit Number:
Legal Description ' G p /( s -27c--
Valuation of Work $mss Cpy oor • ea o q t Parcel # / d 2 3 z p
Proposed Work heated cooled Zf/LS"f' t
n heated/cooled 3 y ��
Class of Work (circle one):
New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): an existing structure, is a fire sprinkler system installed? (Circ one : esid i
Florida Product Approval #/c.. ,s es o N /A
For multiple products use pro uct approve o rm
Describe in detail the type of work to be performed: I
Proneriy Own I nformation
Name: ST )1. wt-v) , 'e AK.. d u
City Address: .,,.c -p., -l
E -Mail or Fax # (Optional) State Zip - - Phone : Ag - .�-0
Contractor Information:
Company N. e: Caw t N
is , 1 ,
$ �� `y Qualifying Agent: i _
- / y_ 7 9v Contact City m'4.. x State LLL____._
Address.—_(,,,, Zip Certification/Registration # CC Job Number 3,7 , Fax #
P �
Office Phone
Architect Name & Phone #
Engineer's Name & Phone # - - ��� -1«�
��
Fee Simple Title Holder Name and Address • iY
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 cert4 that no work or installation has commenced r'
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for period of six 6 months p time to the
work is commenced. understand that separate permits must be secured for E lectrical Work, Plumbing, Signs, J hoc. This permit becomes null
Tanks and Air Conditioners, ners, etc p O at any time aftr
S, g ,Wells, Pools, Furnaces, Boilers, Heaters,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE OF
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINA FOR IMPROVEMENTS
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO, CONSULT WITH
COMMENCEMENT. YOUR NOTICE OF
1 hereby ertify that 1 have read and examined this a placation and know the same to be true and correct, All provisions of laws and ordinances of work will he complied with whether specified herein or not. The granting of a permit does ✓
proviriorrs ofany other federal, state, or local law regulating nc n not presume to give authority to vio ate owcanc� the
gu g construction or the . erf of construction.
Signature of Own: . 1 < a �l /,/
V lrjylpi Signature of Contractor `
Print Name .+ /
Print Name G2 4 ;4 ;:
Sworn to and subscribe. • f e e me r �`� •
this D. 0 20 1-- Sworn to and subscribed bef re me
0 / this ) $ D.y of RIVI 20
Not. 1 1 IC 91 . . .iitVJ t• •
�'�' uaic st a g e a F lorida �A �3I�
. Tory Hamlin N otar y �h Notary Pu • is State • • : a
Z My Commission EE 175845
Tory Hamlin
p f Expires 03/04/2018 f My Commtssi /2 EE 1 eVised .1.26.10
or p d Expires 03/04/2018
Doc # ''012153220, OR BK 16007 Page 1696
NOTICE OF COMMENCEMENT Number Pages: 1
Recorded 07,20 2012 at 1148 AM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
Permit No. COUNT
Tax Folio No. RECORDING $10 00
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real P ro Peth', and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1 .Description of property (legal description): 4
a) Street (job) Address:
2.General description of improvements: '� ` '' 1 - ,.
3.Oner Information
a) Name and address:
b) Name and address of fee simple titleholder (if other than owner) ',
c) Interest in property
4 •Contractor Information
a) Name and address:
b) Telephone No.: �" `''fr
5.Surety Inf -'
/t .fl }
G �e S,
�� a
�- ,� ,� � , Fax No. (Opt.) ' � �
v — a ' .- /tea 2 ewyra
'''•\ Y a) Name and address: %' ;,,
' b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
a) Name and address: * ,; _
Pne No.
7. Identity of person within the State of Florida desiate by owner upon w om notices or other documents may Name and address: ; 's,�, v' e) i, : y be served:
b) Telephone No.: 4
8.In addition to himself, owner designates the followin Fax No. (Opt.)
g person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.:
9.Expiration date of Notice of Commencement (the expiration date is one y a from h date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, 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 YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
ST q 8 • , ,
Public State of Florida l 0. C . `-- — _,:'
. . Tory Hamlin l
Signature t f Owner or Owners Authorized Officer /Director /Partner/Manager
My Commission EE 175645 1 t �� 9n
No R Expires 03/04/2016 p U v ! �.
Print Name " "
The foregoing instrument was acknowledged before me this
day of 20 1 /
2 -, by
(type of authority, e.g. officer, trustee,
A iii;
attorney in fact) for Q .
(name of party on beha I f om instrument
Personal] Known ,� O R Produced Id �)'
Identification Notary Signature i,�
low Type of Identification Produced Name (print) \
Y
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of er u I declare that I have read the foregoing facts stated in it are true to the best of my knowledge and belief. P n , going and that
FORMSMOC,rvsd2010
Signature of Natural Person Signing (in line # 10.) Above