378 Sargo Rd roof 2012 ✓�� CITE OF ATLANTIC BEACH
^` !' 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-0001177 Date 9/12/12
Property Address . . . . . . 378 SARGO RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO EE UPDATED
Application valuation . . . . 6000
--------------------------------------- -----------------
Application desc
roof
--------------------------------------- --------------------------
Owner Contractor
------------------------
------------------------
DONOR, JOSE P JR GOLDEN HAMMER RESTORATIONS
% LORI D SANDERS 4422 MANCHESTER RD
12603 FISH HAWK LANE JACKSONVILLE FL 32210
JACKSONVILLE FL 32225 (904) 880-2004
--------------------------------------- ---------------------
Permit . . . . . . ROOF PERMIT
Additional desc . -
Permit Fee . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . 9/06/12 Valuation . . . . 6000
Expiration Date . . 3/11/13
--------------------------------------- ----------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STA"E DBPR SURCHARGE 2 . 00
-----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- --- ------ ---------- ----------
Permit Fee Total 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904) 247-5826 F x (904) 247-5845
fl r i=
Job Address: 3-1 e> CIA' fZ0CkJ Permit Number:
��P rcla-4 aims CAnL-J- Z
Legal Description 3 - 1(P- 3 B- 2c1 Parcel#
oor ea o q. t. �� p��' q. t � tt
Valuation of Work$ �01��,Cr� Proposed Work heat cooled\— non-heated/cooled ly
Class of Work(circle one): New Addition AlterationRepD' Residentiak--,
Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(gircle one):. Comme
If an existing structure,is a fire s pkle sit stalled? (Circle one): Yes No N/A
Florida Product Approval# t�
For multiple products use product approval form
Describe in detail the type of work to be performed:
Q-�_r r �0-0►--� (I
Properly Owner Information: €
Name: P.. OD yl uy- � J � Address: 1
City t oun + Stat LZip 2, 3Phone, 15 - 1
E-Mail or Fax#(Optional)
Contractor Information:
Cso[G�-� 1 �-1 '
Company Name: Qualfyin Agent:
Address:
.City % cll"C State Zi
Office Phone •"2O Contact N�}in er Fax# , -
State Certification/Registration# &8:2)
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Add ess
Bonding Company Name and Address t V
Mortgage Lender Name and Address
Application 1s hereby made to obtain a permit to do the work and installations as indr"sated. 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 lalws 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 a_pertod of six6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrca! Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
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 TAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFO E RECORDING YOUR NOTICE OF
COMMENCE ENT.
1 hereby certify that 1 have read and examined thisplication and know the same to true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether speci ted herein or not. The granting t f a 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 peFfo mance of construction.
E
Signature of Owner r S gnature of Contractor �Zl
Print Name 1- Q�n�Y int Name �f;�2 _(r1✓.��5
...... .... _. ....»..».._....».....°_.....».._.........................»......._........._ I ........... _ _.:.�°._»...._..........
._
Swo to and subscribe before me Sworn to and subsc 'b d'before me
this � 1 Day of 20 I Z is Day f 20�
REBECCA NOEL
Notary Pu ig ��'-: Notary Public •State of Florida No Pu a � KAREN STUDVM
• :•:My Comm.Expires May 15,2015 MY CO ISSION t E 14 1
%? Commission k EE 58670 ? J/y�) * * e6.10
Bonded Throuoh Naoonal Notary Assn �L � —£y "` �r� ��' Egw&dThtu6u*Notary Services
SEP-6-2012 14:16 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/1
NO'T'ICE OF COMM NCEMENT
i
� 4
State of fl--o--rx�•4 cA a. Tax Folio No-
County
County of d.l"al
To Whom It May Concern:
The undersigned hereby informs you that improvements will,be trade to mium real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE O COMMENCEMENT.
Legal Description of property being improved: (0 - -2
Address at property being improved: a,.-72) o-&-cir) ;j
General description of improvements: � t� �
OT-
1AGAIS
;
Qwncr �YAddiess•
�
(�
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner)—
Name;
Contractor: CY701 121r, it ) 1n
Address kt r, z lk E -32716
'telephone No.: ][a � Fax No:
Surety(if any) 0 L-.•f jj�'K
Address: - .1 IJ --Amount of Bond$ { rL
Telephone No.T - _ _ '17—No: _ Ow 0 2012192328,OR 8K 16060 Page 431.
NumbeName and address of any person making a loan for the construction of the• pro Record P 1
Recorded 49/0&2012 at 02:42 PM,
Name: .1IM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECPRPINU$10.00
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other. documents may be
served: Name: -- _
Address:_ ? _• 1
Telephone No: 9C. :31 '5 , ( '1 Fax No:
In addition to himself. owner designates the following person to recei a copy of the .Lienor's Notice as provided in. Section
713.06(2)(h),Florida Statues. (Fill in at Owner's option) ,
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(I year from the date of recording unless a different date is
specified):
TMS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: l pate:E
119MCA NOEL AefnKc me1I, day of in the ourrty of otrval,State
NottF Y PmIhC-Swe of Roma Of Florida,bas personal appearod. f
• MI CA na.•Exyim alt ls.2015 Notary Public at Large, tate of Tlgridaz ounty of Duval.
mien•EE.N$?O My commission expires:. _� l 1�J T 01615
low T ooayhNNiet>tlltolaryPR. Personally Known- � _ - __ or
Produced Identification: