408 Irex Rd Roof 2012 t CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-( 0000992 Date 8/01/12
Property Address . . . . . . 408 IREX RD
Application type description ROO1 PERMIT
Property Zoning . . . . . . . TO EE UPDATED
Application valuation . . . . 3380
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Application desc
REROOF - TOUCH DOWN
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Owner Contractor
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ISLEY, JR. , RALPH RON RUSSELL ROOFING INC
408 IREX ROAD 4419 HUDNALL RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 636-9909
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3380
Expiration Date . . 1/28/13
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Special Notes and Comments
NEED RECORDED NOTICE OF COMMENCEMENT
PRIOR TO FIRST INSPECTION
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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 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 A PLICATION
CITY OF ATLANTI BEACH
800 Seminole Road, Atlantic each, FL 32233
Office (904) 247-5826 Fa (904)247-5845
Job Address: q0T IIZX grk 31t.53 Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. sq'
t
Valuation of Work$ 33 n(9.CC) Proposed Work heated/ ooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repa r Move Demolition pool/spa window/door
Use of existing/proosed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprin er system installed? (Circle o e): Yes No N/A
Florida Product Approval# q.
`l Y71.7-0
For multiple products use producf approval form
Describe in detail the type of work to be performed: Ae, D (�rwll dAwiq)
Property Owner Information:
Name: A� Address: Q t ` 664. R 22 3
City c State Zip 223 7 Phone
E-Mail or Fax# (Optional)
Contractor Information: /r
Company Name: 1j041 Ro-456t-L kwjAll 4y �iUG• Qualifying Agent: I Ik6 611/14/7
Address: WWI fist/ ii,Zf,R • T City State F&Zip 2.247
Office Phone 7/Lf-1107 Job Site/Contact Number -///Y Fax# 6319?49'
State Certification/Registration# :GG 2 4
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 obtain a permit to do the work and installations as indic ted. 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 la regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is s spended or abandoned for a period of srx6)months at any time after
work is commenced I understand that separate permits must be secured for Electric !Work,Plumbing, Signs, Wells, Pools, urnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILUTO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR P YING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO O TAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFOR RECORDING YOUR NOTICE OF
COMMENCE ENT.
I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether speci aed herein or not. The granting o a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or Ioc�l law regulating construction or the perjbri Piance of construction.
r
Signature of Owner Signature of Contractor -
Print Name K1Z ......... .............., ........................................K Print Name
�
... .............. L......................... . ....................................
Sworn to and subscribed before me Sworn to and subscribed before me
this 3C Day of -Tol"I 20 1 L thi3 31 Day of --�o/LwuiipcmigicHARnqnN.sg,20 /-&-
WXM
CARL RICHARDSON.OR / NO �SE
IC
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otary Publi $TATE OF FLORIDA tary Public Comm# OI8539
Comm#EE016539 Explraa R/� RIDA
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- -, - ---- --- ---— - ---1
NOTICE OF COMCEMENT
{PREPARE IND ICATEi
Permit No. Tax Folle No.
State of FLORIDA County -
To whom It may 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 fol owing information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
Address of property being improved: VorZ
General description of improvements: Me ncoo
Owner ;P*,t,0,V 44r
Address We t
led VA
Owner's interest in site of the improvement Q WA 14FJq
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Ron RusWI Roofing,INC.
Address 4419 Hudnall Rd.Jacksonville,FL.32207
Phone No.9D4-714-1907 Fax o. 904-636-9909
Surety(if any) NIA
Address WA Amount of bond S NIA
Phone No. NIA Fax N o.
Name and address of any Arson making a loan for the construction of the improvements.
Name
Address NIA
Phone No. NIA Fax No. N/A
Name of person within the State of Florida.other than himself,chisignated by owner upon whom notices or other
documents may be served:
Name Ron Russell Roo&V,INC.
Address 4419 Hudnall Rd.Jacksonville, FL.322 7
Phone No. 904.714-1907 FaxN 904-636-9909
In addition to himself,owner designates the following person to r Iceive a copy of the Lienor's Notice as provided in
Section 713.06(2)W.Florida Statutes.(Fill in at Owner's option,.
Name NIA
Address NIA
Phone No. NIA Fax No. NIA
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY WNER
Betwe m. Is �,� I` DATE
County of Duval.State at Florida,has personally appeamd
twaM
him"IV hermit ,alms that all stelerrleMs and dedarallons h raln by
aro true and acc rate t11XW C1fPL R--, &A SR
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WATE CIF FLOP"A
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Nobry PubtlC at aryel�1Z1201d,
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