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583 Royal Palms Dr 2012 roof KIS CI*Y OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12- 0001159 Date 9/04/12 Property Address . . . . . . 583 ROYAL PALMS DR Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 7500 --------------------------------------- ------------------------------------- Application desc REROOF i Owner Contractor GALLAGHER, GLENN T J & M ROOFING SERVICES INC 583 ROYAL PALMS DR 2021 ART MUSEUM DR STE 115 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 399-5546 --------------------------------------- ------------------------------------ Permit . . . ROOF PERMIT Additional desc . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 7500 Expiration Date . . 3/03/13 Special Notes and Comments need noc --------------------------------------- ------------------------------------ Other Fees . . . . . . . . . STA E DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ----------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- --- ------ ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF TLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICAT N 1� CITY OF ATLANTIC BERCI. - 800 Seminole Road, Atlantic Beach, FL 32233 1' Office (904) 247-5826 Fax (904) 247-5845 Job Address: Permit Number: Legal Description �- Parcel# 30^ y•3 ^2_S__ t Valuation of Work$ S p© oor rea o q. E. t t Proposed Work heate /cooled non-heated/cooled Zy3(0 Class of Work(circle one): New Addition QA Iteration Re it Move Demolition pool/spa window/door Use of existing/proposed structures)(circle one): Commercial iResi If an existing structure,is a fire sprinkler system '4nstalled? (Circle gone). es o N /A Florida Product Approval # Z -Pi For multiple products use product approval form Describe in detail the type of work to be performed: d©j Property Owner Information• Name:Q IL Address: m (D-), City' Stat ZipPhone E-Mail or Fax#(Optional) Contractor Information: Company Name: Qua li ging Agent: (A'%L a.E L(<p=-)4 � Address:Z02 S 't1 02 City i3,<l�li State Ft Zip�_ Office Phone - -S Job Site/Contact Number Fax State Certification/Registration# 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 indicated 1 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 law v 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 suspended or abandoned for aperiod of six 6)months at any time after work is commenced. I understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, Wells, Pools, furnaces, Boilers, Healers, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILU E TO 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. 1 hereb certify that t have read and examined this a plication and know the same to be rue and correct. All provisions of laws and ordinances governing this type ojxwork will be complied with whether speci ted herein or not. The granting ofp permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the perfor ante of construction&LEp— S Signature of Owner �G Signature of Contrac Print Name ��.. ........... -(1.t .-t1.�..�1.��-................... Print Name �e 1...... . ........................................orn to and subscribed before me Sworn to and subscribed before me t s Z G of --111 [i 5 i 20 17 th' ZD Day f (a V w ( 20 iZ N tary Public �►�•• N No ry Pub is Notary Public State of Florida w. A.-Ah- Notary Public Stye of Florida Marcus J Ahler§ . . Marcus J Ahlers 0 My Commission EE 219940 # tJg�app or 0.0 Expires 07/26/2016 N t� �✓ � OWI"40 j NO'- "VE OF CO ENCEY ,NT (PREPARED IN DI PLICATE) -� Permit No. Tax fallio No. State of Florida _ Count of Ouval To whom it may aonoem: The undersigned hereby informs you that improvemen is will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the followhig information is stated in this NOTICt OF COMMENCEMENT. Legal description of property being improved: Al Address of prope Bing improved! General description of improvements: Re-Roof Owner Address Owner's interest in site of th provemen# Fee Simple Titleholder(if other than owner) Name Address Contractor &M Roofing&Res oration Address 2021 Art Museum Drive suite 115—Jsc nville F 32207 Phone No.904-399-5546 Fax No.904 9-5023 Surety(if any) Address ,Amount of bond$ Phone No. ax No. Name and address of any person making a loan for the construct on of the improvements. Name: Address Phone No. F x No. Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: Address Phone No. Fa No. In addition to himself,owner designates the following person to receive a copy of Lienoes Notice as provided in Section 713.06(2)(b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No_ Fax o 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 E R Signed: DATE: Before me thi day or in the Co t of D I St t of Florida har,,pOrson ally appeared EW NurDoc b 20tages:1 fi.OR BK 1805fi Page 2121, Himselflhersel and affirms that all statements and declaration herein Number Pages:1 are true and a urate Recorded 09/04/2012 at 02;18 PM, �� JIM FULLER CLERK CIRCUIT COURT OUVAL S" e" KENNEDYAMIAu =,JFl. COUNTY � WCOIIMSION915O89 W RECORDING$10.00 EXPIRES:Jarnrarryy 10,2018 890d TAN Notary Pubb UndeWito Notary PublIC i it Large,State of Florida County ofb",; My commissiol I explre5:T �j�/7 Personally Know or Produced Iden kation F TO/T0 39Vd JOON wr 6Z09666b06 ZV:OT ZTOZ/90/60