871 Ocean Blvd 2012 roof CIT' OF ATLANTIC BEACH
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800 SEMINOLE ROAD
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ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001001 Date 8/16/12
Property Address . . . . . . 871 OCEAN BLVD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO 13E UPDATED
Application valuation . . . . 4950
--------------------------------------- -------------------------------------
Application desc
REROOF
--------------------------------------- -------
Owner Contractor
_ ------------------------
BOOTH ALLISON J ET AL & GEORGE TOWNSEND ROOFING &
PATTERSON KIMBERLY B CONSTRUCTION SERVICES
2003 SW LAREDO ST 10418 NEW BERLIN RD # 115
PALM CITY FL 34990 JACKSONVILLE FL 32226
(904) 645-0796
-----
-- Structure Information 000 000 RE OF
-----Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee 75 . 00 Plan Check Fee . 00
Issue Date . . . Valuation 4950
Expiration Date . . 2/12/13
--------------------- -----
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 APP�tOVED ONLY IN ACCORDANCE WITH ALL CITY O 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: RRq Ocean Blvd Permit Number: A / p7o
Legal Description - - T Parcel # 170236-0016
Floor Area o q. t. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Rep it Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Re-sidentia
If an existing structure,is a fire sprinkler system installed? (Circle ne): es o N /A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed:HydrO-StOD Poof Application
Property Owner Information:
Name:Kimberly B. Patterson Address: 104!42 Bosahan Ct
City Carmel State IN Zip 46032 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Towgsend Roofing&Construction Services, Inc. Qualifying Agent: Randy Townsend
Address: 10418 New Berlin Road#115 City Jacksonville State FL Zip 32225
Office Phone (904)645-5887 Job Site/Contact Number 904 472-4479 Fax# (904)645-5442
State Certification/Registration# CCC1326289
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 herebv made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards of all M vs regulating construction in this jurisdiction. This permit becomes null
and void rf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electr cat Work, Plumbing,Signs, Wells,Pools, Furnaces, Boilers, Healers,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENTMAY 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 here b%certi6,that I have read and examined this application and know the same to e true and correct. .411 pro;uons of la s and ordinances governing this
ope pltwork�will be complied with whether specified herein or not. The granting f a permit does not presetto give uthori to violate or cancel the
provisions ofanv other federal,state,or local law regulating construction or the perfi7nance of construction.
Signature of Owner Signature of ContractorCV
Print Name tJ i o pn��p�a„ runt Name Randywnsen............................................................................
..., llr..................... r
Sworn to and subscribed before meT'�,p ms's, worn to and subscribed be ore me
this�Day of i '%tj is of -Ti k L 201
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Notary Public
�;*a'°�e', COR 8 LINGER
Laura M. Batz _
I, ��' � ���•`�` '•�' ,`�': Notary Public-State of Florida
Nota Public-�hlo "���OF O�`,- '=p�A�o My Comm.Expires Mar 25,2014 evised Ol.26.10
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•:;F����J;r Commission�DD 974849
.My Commission Expires 01-26-2015
Aug 1612 04:58p Townsend Roofing 904-645-5442 p•2
NOTICE 4F CCN! ENCEKENT
PemliNo 1 c�� v�" � 010 TaxFoli No_
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Slate of {�J �i(nQ- County (2✓
To whom it may concerts
The undersigned hereby informs you shot ill1ploveimeiiLs will be made to certain real property.and In
accordance with Section 713 of the Florida Stattnes.the following information la stated in this NOTICE OF
COMMENCEMENT.
U,gal eescrtquon of ropes e a improved
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,0.Cdress of prop>lrty being ny1¢yro�ed I �� j • �'
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Expiration date-of Notice of Commencement ithe expiration ijale is one(i)year from the dare o'recordrrrg unless a
de.%ient date i3 apeafred)
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