Permit Roof 835 Plaza 2012 � SA CITY OF ATLANTIC BEACH
r .� s) 800 SEMINOLE ROAD
Jf X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
JJ3 !J
Application Number 12- 00000976 Date 7/30/12
Property Address 835 PLAZA
Application type description ROOF PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 5000
1-
Application desc
reroof
Owner Contractor
SILVERIO, MANUEL JUSTIN LARSEN CONSTRUCTION INC
835 PLAZA PO BOX 1942
ATLANTIC BEACH FL 32233 4784 CATTAIL ST
MIDDLEBURG FL 32068
(904) 241 -0320
Permit ROOF PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 5000
Expiration Date . 1/26/13
Special Notes and Comments
need noc
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 75.00 75.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILD NG 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: 1335 P`a ,c-r-'Y
e Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 5 000. Proposed Work heated /cooled
non- heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (circle one): Commercial _ ntia
If an existing structure, is a fire sprinkler system installed? (Circle on j esc-- o) N /A
Florida Product Approval #
For multiple products use pro uet approval form
Describe in detail the type of work to be performed: J10 ,
Property Qwner Information:
uI< ■
Name: S A A, S 1 I_ Address: a55 p• s 40;
City IMES -7 State a Zip -? Phone -:s:=. •z %,1 1.- A..=;44 �4741ff ifi
E -Mail or lf'ax # (Optional)
Contractor Information:
Company ' ame: , ..4_... • ) /,SLr/ ` `-�� ��Si'.. �•. .0 alifyi g A Address: 4 i !�i!C�'!! '" , City u; z ' 4 . i t State '/ Zip SW
Office Pho e i — It Job Site/ Co tact Number \ ax #
1.
State Certiffcatio ' egistration # ( CJ 9(x`
Architect Name & Phone #
Engineer's Name & Phone # /`'✓ /q
Fee Simple Title Holder Name and Address
Bonding Company Name and Address /9-
Mortgage Lender Name and Address
Application 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 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 constr,Petion or work is suspended or abandoned for aperiod of six (6) months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Healers,
Tanks and Ait! 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
1 COMMENCEMENT.
I hereby certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authori . •'olate or , cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction. 0 # _...........
Signature ofOwne ` v , _ _ , . Signature of Contractor
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Print Nam; . .tom r7 w. CVO
o� P N ame L . -
Sworn to = , / bscribe • •. • i 0
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/ � SwoTi for s . cribed f.
this
this . l• l 20 0� 4 S " •' ■ ��
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Nota P p
I, Not.' P • Vc -
I Revised 01.26.10
1 Ct MARIA PIMIENTA
�' '` ° MANIA PIMIENTA
.:4'-.: Notary Public -State of �'n rida
Tres Ja Notary Public - Stale Of Roddy
' Ex p a ; My Comm. Expires MI K 2016
`� �. C ommissir , Commission 0 EE SOON
JUL -30 -2012 12:03 FROM: TO:92475845 P:1/1
Doc # 2D12159876, OR 9K 16016 Page 218,
NOT10E OF COMMENCEMENT Number Pages: 1
Recorded 07/30r2012 at 12:07 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
Permit No. (7 (� - . ^ COUNTY
�i OUNTY NO 610,00
To Niglio No.
T11I: WNW:ASK:NE() hereby gives notice that improvements will be made to certain real property, and in• accordance with Section
7 1 3.1 3 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT -
!Description of property (legal deeriptio.'i)
a) Street (fob) Address: 5,... Ej -- : _. - :... fl+fa.•+ f.'c c ' ..., FL 32-7,. 3.
2.General description of improvements: )-i.Pt'�f _.._ .
3.Owrlcr Information .. . . ... . ....._—__—..__— -- —
...•—
a) Name and address: r
b) Name and address of fee simpl itle older Vogler than owner) A-V
c PrOPeity
i Interest in '
-- --
A 4.Con#raetor information `t' tip "
, U a) Name and add -- ► I. I - .. .... ,K u • s ri0 R —.. i ! el- 3..'7-06$
j I b) Telephone No.: -. 4, Wil lill" Fax No, Opt.) _' Ot{ _ _' Q / 71re
5.Suraty Info
a) Name and address: •..,-- -..... --
h) Amount of Bond. - - - - -- -- - - -- — - .._... .. . __.
c) 'Telephone No.: Fax No. (Opt_)
C,.l,cndcr
a) Name and address: _ `.l __ '__ -
Phone No.
7. !density of person within the State of Florid csignated by owrycr upon whom notices or other documents may be served:
a) Name and address: ..._.. - - - -- -- -..... .........-- -_ -_-_ .....
b) Telephone No.:... / Fax No. (Opt.) . __
Kin addition to hirnaelf, owt►et designates the ?following person to receive a copy of the Lienor';5 Notice as provided in Section
713,13( I )(b), Florida Statutes:
a) Name and address: ti
b) Telephone No.: ] Fax No. (Opt.) _ _ .. .. _ ._ ..
9.Ext>iration date of Notice of Cotturieneemen • the e xpIi it m dirge Is one year from the date of recording unless a different date
WARNING TO OWNER: ANY PAYMENTS MADE BY TIIE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCt�'MENT ARE CONS1'I)ER.ED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I., SECTION 713 -I3,
FLORIDA STATUTES, AND CAN RESULT IN 'YOUR PAYING TWICE FOR IMPROVEMENTS TO Y01.1R PROPERTY.
A NO1rJCF. OF COMMENCEMENT MUST 1RF ItWORDE1) AND POSTED ON THE OR SITE RB;FORF TIE FIRST
INSPECTION. 11■ YOU INTEND T'00.WEA.MN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY RW I'ORE
COMMENCING WORK OR !RECORDING YOUR NOM": ir, or c.:ommEricEENT.
brATkt1F PIA /AMA ( cotlfiTv op. ' , PULA AS 19 l \ I
. S. ature ofOwra:r or w er'a no, ,i,,cd 3 r IC nxt ,, � e �•Ialer7Menagcr
Print Name.
The foregoing instrument was aeknowledgod before site this day of . , , 20 )a, by /L./a_ .
�
__._ .. a C ' �'. ---- (type of authority, c • • ftii¢er, tn' .
A ktorn4 In fort) for 835 pI e __ -, .(a*tttc of party ..i, till • � r teat wig a ted).
Person illy Known t." Produced Identification Notary Signitu. '
r
Typc OT Identification Ptoxluocd Name (print) _. ... .. -__ ...1-/Agi { ._.P.11411456-1724.-
_. P.114'1 ...
OR
Vcriliigation pursuarn to Section 92.525, Florida Statutes. Under pena.lti of perjury, 1 declare that 1 have read the foregoing and that
the fr+c•,ti stated in it arc true to the best of my krtowlcdps. rind belief,
I
Sir�nnl,ptr of n r +lrx Primo, :tiir;nin;; (in li 'i " ' ` . MARIA @7MItEIIR
6 _,� notary Public 'Stet! 0/ flffridrl
a.= :. fyt Comm Expos An 28.2o1S
} • .• . , :? Commission • i EE SO