1157 E Linkside Dr 2012 roofCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-(
Property Address . . . . . . 1157
Application type description ROO1
Property Zoning . . . . . . . TO F
Application valuation . . . .
----------------------------------------
Application desc
REMOVE AND REROOF
----------------------------------------
Owner
------------------------
DERKSEN JELTSJE
1157 LINKSIDE COURT E
ATLANTIC BEACH FL 32233
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Permit . . . . .
. ROOF PERMIT
Additional desc .
. TEAR OFF AND ]
Permit Fee . . .
. 100.00
Issue Date . . .
.
Expiration Date .
. 2/25/13
---------------------------------------
Other Fees . . .
. . . . . . STA
.00
STA
---------------------------------------
Fee summary
Charged
---------- ---
-----------------
Permit Fee Total
100.00
Plan Check Total
.00
Other Fee Total
4.00
Grand Total
104.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY
BUILDING CODES.
D001129 Date 8/29/12
E LINKSIDE CT
PERMIT
E UPDATED
9675
------------------------------------
Contractor
------------------------
HOMEOWNER BLDG SVCM INC(ROOF)
739 BROOKMONT AVE E
JACKSONVILLE FL 32211
(907) 322-1054
------------------------------------
F
Plan Check Fee .00
Valuation . . . . 9675
----------------------
7E DCA
SURCHARGE
--------------
2.00
7E DBPR
SURCHARGE
2.00
-------------------------------------
?aid
Credited
----------
Due
-------
100.00
----------
.00
.00
.00
.00
.00
4.00
.00
.00
104.00
.00
.00
ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING PERMIT
CITY OF ATLANT
800 Seminole Road, Atlanti
Office (904) 247-5826 F
Job Address: psis
Legal Description 4q-2.3 1'1-2S-2.°lG Sc,lVa f�Nl:Slo�
Floor Area of Sqt.
Valuation of Work $ q �o i s Proposed Work heate.e
PPLICATION
C 13EACH
Beach, FL 32233
K (904) 247-5845
Permit Number:
5q.rt
non-heated/cooled
Class of Work (circle one): New Addition Alteration a Move Demolition pool/spa window/door
Use of existing/pro used structures) ((circle one):. Commercial <sideIf an existing structure, is a fire sprind�ler system installed? (Circa one)N /A
Florida Product Approval # L7001,
For multiple products use product approve omni
Describe in detail the type of work to be performed: df -F 4tjb Z6,4oF
Property Owner Information:
Name:. e. Pe r
City
E -Mail or Fax # (Optional)
�l State
6' <O S/ D 6
31 -inn . Cf 0 Z— 2 1 C
Contractor Information:
Company Name:Al 6Ow N E tZ 6)d'$ • :50 C . Qua if}
Address: 73 Z3 Col<vvt<pyI (+1/9 City.
Office Phone vV 3Job Site/ Contact Number o
State Certification/Registration # U S7 Ff
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
issuance of a permit and that all work will be performed to meet the standards of u
and void if work is not commenced within six (6) months, or if construction or wa
work is commenced. 1 understand that separate permits must be secured for El
Tanks and Air Conditioners, etc
Agent:
- v'116
oto 7- z7_
916 11110ee
State Zip 3Zz
Fax #
ed. I certify that no work or installation has commenced prior to the
regulating construction in this jurisdiction. This permit becomes null
rpended or abandoned for a_period of six 6) months at any time after
Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Healers,
WARNING TO OWNER: YOUR FAILTO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO TAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY DEFO RECORDING YOUNOTICE OF
COMMENCE ENT.
I hereby certify that I have read Wined this application ar
hpe of work' will be con: with whether specified herein or
provisions of any other mal, state, or local law regulatinper!
Signature of O
Print Name
Sworn to and subscrib ff before me
this -,�Ts- Day of 61-,zt
same tole true and correct. All provisions o laws and ordinances governing this
;ranting a permit does not presume to t e authority to violate or cancel the
the pert mance ofconstruction.
S '?nature of Contract
fu,�Z�
Public
VIG'Uli KARNAUCH
Nutaty Public -State of Florida
My Comm. Expires Aug 15, 2016
Commission 0 EE $27202
r -2 -
Name
+ �
�-
Name................................/\...................
and subscrj%d before me
H. MORRIS
-tfble(y Public - State of Florida
My Comm. Expires Mar 2, 2014
NOTICE OF
State of D,t✓! /�
County of ✓,� �-�
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to
the Florida Statutes, the following information is stated'this NOTICE C
Legal Description of property being improved: `y` � —.23 i 1
sc�lr/g L!�
Address of property being improved: / I S 7 EA S i
General description of improvements: % 4,Z ar-r— f} NI)
Owner: SCI T5J a DF—R-m N Address:
Owner's interest in site of the improvement:
Fee Simple Titleholder (if other than owner):
Name:
Tax Folio No.
real property, and in accordance with Section 713 of
1o6 (/I/\/ 17- r
J
O Q
Ln >
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n.
rn O
Contractor:+'h L v W N c: 2 til. L L i\J X
v
(/_ C— 0 o
32 �" `� % dC `i
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Address:
X is U
Telephone No.: !j U q 3 ZZ t Fax No:
O C"I Y o
CjU
J
Surety (if any)
°
Address:
Amount of Bond $ ° 0 w
noroJrc.,
Telephone No: Fax No:
N N 6 h 2
U € 0 LL
Name and address of any person making a loan for the construction of the '
provements U z e- :�; 0 W
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designate
by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to rece ve a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
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 OWNER
Signed: v
Before me this C
VICTOR 1(AjiNAUCH
Of Florida, has per.
`"s Notary Public . State of Fimid Notary Public at Le
My Comm. Expires Aug 15. 2015 My commission ex
Pc Personally Known:
Commission # EE 82720
Produced Identifioz
. - -- Date: -�
r—day of -r :u'r. in the County of Duval, State
ly appeared :-7-7-
State
State of Florida, County of Duval.
or