Permit Roof 453 Camelia St 2012 CITY OF ATLANTIC BEACH
^' !" 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jit i-
Application Number . . . . . 12-00001443 Date 10/02/12
Property Address . . . . . . 453 CAMELIA ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
---------------------------------------------------------------------------
Application desc
REMOVE AND REPLACE SHINGLES FL 5444-44
----------------------------------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
BORGES CHERYL C MANNY- S UNIQUE REMODELING INC
453 CAMELIA ST 8362 CROSS TIMBERS DR E
ATLANTIC BEACH FL 322332519 JACKSONVILLE FL 32244
(904) 482-9565
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 3/31/13
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE 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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904)247-5845
Job Address: `i 5� CaMe��Q �j - Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ �,000 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition poouspa window/door
Use of existing/pro osed structure(s)(circle one):_ Commercial esidential
If an existing structure,is a fire sprinkler system installed? (Circle one): o N/A
Florida Product Approval# Ft +i R-y ^FL 15 LQ-1
For multiple products use product approvalorm
Describe in detail the type of work to be performed:
Property Owner Information:
Name: Ch eta N '& qS Address:
City �t Q;M,L State Et Zip T22-5 Phone - 1 0
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: T o A0. \4!5 ` i Aut tU jQ ji��Qualifying Agent:
Address:EG(-�2c{T,s, S 'i>C, E, City m State Zip -S'?
Office Phone Ot o\A- 4-82- 4(S:L-c:- 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 laws regulating construction in this jurisdiction. This permit becomes null
and tf 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 per
must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and irConditioners,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.
I hereb 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 specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provtstons of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name �A\). _�........
Sworn to and subsc bed before me Sworn to and subscribed before me
this;�l Day of "\o Oe >°Y , 20 '� d— this ' Day of ryx4 -e 20 \
N t ' 1&IY I SIGN k EE181328
��IY COMMISSION#EE181328 EXPIRES March 21 16 .
EXPIRES March 21 2016 Kevis d 01.26.10
(407 398-0153 14071398-0153 FWW8N0tWVSenka.,0rn
F1WdeN0hMySoMce.WM
` NOTICE OF COMMENCEMENT
State of Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
Address of property being improved: `q 3 Ca je
_
General description of improvements: r S"uS
Owner: V'0-fY� ,�i'; Address: �)i
Owner's interest in site of the improvement:_VE4
Fee Simple Titleholder(if other than owner):
Name:
—
t"Contractor: '� 2 �'t� t
Address- `Z CIO O �i �I.� ���� DO 1 '3 2 L�S
Telephone No.: Fax No:
Surety(if any)
Address: Amount of Bond$
i elonhon,No: Fax_T!o
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
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:
Te!_rho: c: -- ---- -- — Fa;c No:
In addition to himself, owner designates the following person o receive 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: �ofDuval'
Date:Before me i, _day ofin the County of Duval. State
Of Florida,has personally appeared xf edDoc#201214500,OR BK 16089 Page 1348, Notary Public at Large,State ofFlorida,CoI
Number Pages:1
RM FULLERd �CLERK at 12:0 PM, DUVAL My commission expires:_ y
Personally Known:
COUNTY Produced Identification: ( y< l :•: MISSION ar EE181326
RECORDING$10-00
'. ,q,,�,,.• EXPIRES March 21 2014
(407)3N-0133 FWk18N0WVSWft*A "