Permit ReRoof 298 Magnolia St 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001397 Date 9/27/12
Property Address . . . . . . 298 MAGNOLIA ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5200
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Application desc
RE ROOF
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Owner Contractor
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SHEY SHARON ALLEN K & G CONSTRUCTION CO INC
1309 NOE CT 7587 WILSON BLVD
NEPTUNE BEACH FL 32266 JACKSONVILLE FL 32210
(904) 509-8888
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Permit . . . . . . ROOF PERMIT
Additional desc . . RE ROOF
Permit Fee . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5200
Expiration Date . . 3/26/13
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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 60 . 00 60 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 64 . 00 64 . 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
Job Address: o I UA Permit Number:
Legal Description to—b S q LTA`/ �S CL Parcel# (-70S30-0000
Floor Area o q. t. q F'
Valuation of Work$
'5-/')_o0 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structures)(circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# /OG--7L1
For multiple products use product approval corm
Describe in detail the type of work to be performed:
SNI G ':V/
Property Owner Information: ,,
Name: S 149WtJAl 16-0 Address: 1318 NCC—�0"T, 1\)&Pt00'zz E&" R S�v
City Nv R.�, SGAJ, State_Zip 3?-36& Phone
E-Mail or Pax#(Optional)
Contractor Information:
Company Name: k a_(n �r�tJStpj.K` /&" CO° 1N4, Qualifying Agent: AA9-OQ
Address: W t ISo N u City A X State E L,—Zip 3aa0
Office Phone :121?) 1 Job Site/Contact Number Nei' FJ Cd Fax# -77 1-":)q!--
State Certification/Registration# CCC 13300
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 performed to meet the standards of all laws 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. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces,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 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether speci ied 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.
Signature of Ownery66_0 Signature of'Contractor
Print Name """...S AQ;orJ � Print Name " (.G�
Sworn to and subsQribed before me Sworn to and subs ---
this 9 Day 0 X this D of l9R�H 2 /
Notary Publi j r h 9 -2p13 Notary is -%.,;„n3� Ott tes 9 22013
Commission No.DD 922164
SEP-26-2012(WED) 15: 12 BRRCO DUURL (FRX)9047717912 P. 002/002
>aac IF ZU12208674, OR SIC 16081 Mage 2493, Nurnbe= Pages: 1, Recorded
09/25/2012 at 02:55 PM, JIM FUDR CLERK CIRCUIT COURT. DUVAL COUNTY RECORDING
$10.00
NOUCE OF C( MWENCEMNT
State of A,dda Tax Follo No. 17053 0-O fl0 0
Cotmty of: MVAL
To Wb=ItMay Caasern:
11W uadendped hereby tnram s You that impmvements will be mode to ogt4in real Inptarty,and iu naaotdttttoe with Srr4an 713 nfthe Florlde
Su t mt;,the fdllawft la fourudon Is tooted 1n this N07YCE of Co1vQu11;'NCEMMa.
LOPI DrgatipdO0 ofpmperty being improved:
10-9 MTAZR BBC I
Addranarprepettybeing improvect: 298 MAGNOLIA ST., ATLANTIC BEACH, FL 32233
Goncrol damipdan orimproacmcgw-, REPAIRS R900F
owner. SHEY SSI MON ALLEN � Add=13 0 9 NOR CT, NEPTUNE BEACH, FL 3229-6
Owner's lnlerret in wile orthe Improventant:
Fee Slmple'lldebaldar(if other thea oft1w):
Metstc:
Contactor K A SlMIItt>IAM C2.Inc Allmu calla
Addr=.U87 Wltean 131vd.�q* , n }e.F[3=
Tdcow"Na: �•t?88g FmctJa:tea-7yta��z
Sntrty(Irany)
Addtaas: Atnaunt anond S
Te.1comneNot. Fmr No:
Nauta Std address OCany person making a loan for the at:ttatruation of the imprvvemants
Norom
Addnys:
PhoneNgr Fa>`Na
NWM of parsatt within tint State of Flodda, other than h1MWA designated by Owner upon whom tlatiaea or other documents MW he starved;
Naas
Addtmts:
Tdt phone>Wn:` Foto Nn:_ _
In addition la himsdf darner dgsiganta the Iblimving parson to fmive a appy nrthe Uenar's Nodao as provided in Sntlon 713.W(2)(b),irlartda
Stataes, (1±111 In at Owner's optiot0
No=
Addmaro:
Thilephone No: FdxNo
Expiration date Of Nod u of Comm ocatnent(the axpiradon date Is ons year From the date of moording unless a difrerent date Is specilterl);
THIS SPA=FOR RECORDSR13 USE ONLY RIAG
Signed:
Beam thfs 2 d of i,StateOPFlodda, persaaalEy o er�i >
Notary Public-at Large,SlalO ofFlOrld11+td q►nfIDav�L, 0(� d
Personally,Known:
on: dAp N.