Permit ReRoof 501 Aquatic Dr 2012 f f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001359 Date 9/18/12
Property Address . . . . . . 501 AQUATIC DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4450
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Application desc
reroof
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Owner Contractor
------------------------ ------------------------
DERUGGIERO RELDA CATHERINE BRC HIGH TECH ROOF DIVISION
501 AQUATIC DRIVE 6372 GREENLAND ST STE 6
ATLANTIC BEACH FL 322333837 JACKSONVILLE FL 32258
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4450
Expiration Date . . 3/17/13
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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 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 APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF 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
JobAddress: h 0) 0q& t"_ 191%- Permit Number:
Legal Description � Parcel#
C06- Floor Area o q. t. Sq.Ft
Valuation of Work$-99 Proposed Work heated/cooled /,A 0110 non-heated/cooled
Class of Work(circle one): New .Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercialidential
If an existing structure,is a fire sprinkler system installed? (Circle one): es o N/A
Florida Product Approval#
For multiple products use product approval Form
Describe in detail the type of work to be performed: ^� A`` �Z� �
12 32�
Property Owner Information:
Name: 444 Address:5-0) 4q g±± a/t
City /3 State jiZip Phone G 3S-t iI,&
E-Mail or Fax#(Optional)
Contractor Information:
i
Company Name: Qualifying Agent: JClZ44-'9
Address:)tz fo old t'"i 06.aui '-Or / Sw* /SRjo CityTj+i- v,+vUtll.�_ _ State rn Zip
Office Phone C 614 - 2 ft oN3t Job Site/Contact Number Fax#
State Certification/Registration# C C v
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.. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be perforated to meet the standards of all laws 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 sus ended or abandoned for a_pertod of s,z((6)months at any time after
work is
cont,nenced. I understand that separate permits must be secured for EleciricalpWork,Plumbing,Signs, Wells,Pools, 1°urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY 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.
1 here b certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether speci med herein or not. The granting of 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 performance of construction.
4w-k-
Signature of Owner Signature of Contractor G
Print NamePrint Name 'Q,n....... .......C............(,4?. t ......_........................................................_..
Sworn to nd subscribed before me Sworn to and subscribed before me
thisdtf Day of AMerAISr. 20 /oZ. this ? Day of 4041/5 20 /02
s.
Notary P .'
• ;; S. BRIAN HYNES ,�►" S. BR HY ES
MY COMMISSION#DD947667 ": `" MY COMMISSION#DD94766 evised 01.26.10
EXPIRES December 17,2013 EXPIRES December 17,2013
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(407j 38b pt53 FlondallotarySenks.com (407)398 0153 FloddoNgtpiryService.com
NOTICE OF COAD, IE1VCEINUNT
Permi:No. Tax Folio No.
Smic of Florida,Cotrnr.of Duvall
iE i, °DERSI \-ED hereby give notice that the improvement vvill be made to certaia real proper;'in accordance wins
Chang;li,:lorida Statutes,the felicwing infot nation is provided in this�3otice of Comrnencemew,-
1. Description of p o 'Iegal description of property and address if aLm?able):
2. Nene% �Ma o;improvemens:
o /
3. Owner iniormation: O
a,Name and Address: b�
b)Interest,in propem = - .r
c)Nmue and address of sumpte urleholdez(if other than o«-ner):
awv
4. Conz-actor Information:
a) ameandAddress:&C-91jo AMP 42PIJ1'0J.Y.vc i/25oA�D��TI�jkSyw�r�tu�7'e /5�3�3
a' b)Phone Number. !&u -et*V-59131
5. Surety Information: ,q
ii'Name and Address:
b)Phone Niumber__
c)Amourn of Bond:S
Lenderinformation:
a)Name and Address.
b)Phone Number.
M
> ?erson wi`�the State of Florida desi�a-tzted by Ow3er 4,Ot1 ti'liom notii"s aF Otaer d<;cttments Elim be�'�"ed as
N
n provided by 71__13(1)(a)'.,Florida Statute
m x a):'game and Address: I��
a OZ) b)Phone Numbers of Design2zed Person: -
a F I. in addition to h—e= nersseY,Ower designates of to receive a
copy of the Lienors Douce as provided in Section 713.1'(1)Eb),Florida Statutes.
Y
[0 Ofv a)Namme snd Address:
w ro 0 b)Phone Number of person or entity designated by wwner
O CJ Y
m o Cr g 9. E wmxion date of Notice of Commencemeni(the expir non date may not be before the compietioP.of construis 0
co '—Wi and final pavziu::tt to the contractor,but will be one(1)year from the dale of recording unless a different date is
00_ o=J v 1-9svecilled.
CJ NOW _'z
OQ"N J?-� _
It
.fl `2 D Z O `�t'3 N-LN i TO OVNER: ANY PAYN E'_�iS MADE BY THE OWI tI ER At`TER TIM EXPR4.IT0\ O?F THE
o Qa) o w NOTICE OF CG n �IMNI[ENT ARE CO`SIDERED D,eROPER PAYNMgTS LTIDER CHAPTER 713:PART L.
n z ,v SLC tsOl` tL.ORIDA STA. U?ES, 4v'D CAN RESULT Il3 YOUR PAYING iWZCE FOR
WROVENI ?NTS TO YOUR PROPERTY. A NOTICE OF CO�CEMEN-11�iST BE RECORDED AN
POSTED ON TlM jOB =BEFORE THE I-EMST L•NSPECTIOIa. TF YOU INvT04D TO OBTAIN F�?�CitiCs
CONS17LT Cv'iTf3 �'bER.YOUR LOR A_'\T ATTORN-rY BEFORE CON -CING ,%7ORK OR RECORDIIIG
YO;iRNOTICEOFCO..NQ&`CF- EN`T.
Under penal.;elf perjury.=declare that t.have read the fategoing nonce of commencement wid the facts stateu
lieirc we mic m the t o+ i-ow''-'Q and'aeief 1
_ c
i -e of Owncr o:t?�rner's Authoriz ectooP ;. er Signaro-_v's P�iatc'o Name i e
4�/�
T: 2l1 b_
~,e fczegoing ins-a-u+ew w•2;seknotwledged bezono zee t day of `
S •.B/QIA4i �!r/�S as NDTAR'/ f'or EL �I DER6lGG/E�D_.
�;v 2750;1; (]'ype JZ niL•HOTIty,ie. G-r;Attorney) z same oz tiarty Ir z.••�s Exeeurm for)
`'EYP° S. BRIAN HY
NI:'S 1O-,r•. BL.IC,S Q ORID;�
is
: MY COMMISSION# PrinLN
\ane:
• EXPIRES December 17,2013 D (/
(407)398-0153 FloridaNntarySery ce.com Personally L{ttaW 1
�,Iceaixncan onfT}pe.
Revised 10il,'201()