Permit ReRoof 1221 Mayport Rd Unit 1241 2012 CITY OF ATLANTIC BEACH
1 � 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
,
Application Number . . . . . 12-00001453 Date 10/04/12
Property Address . . . . . . 1221 MAYPORT RD
Tenant nbr, name . . . . . . UNIT 1241
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 22000
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Application desc
reroof
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Owner Contractor
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AKRA INVESTMENTS LTD DIBBLE ROOFING COMPANY
PO BOX 7586 3518 MORROW ST
JACKSONVILLE FL 322380586 JACKSONVILLE FL 32217
(904) 731-2835
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 160 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 22000
Expiration Date . . 4/02/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 .40
STATE DBPR SURCHARGE 2 .40
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 160 . 00 160 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 80 4 . 80 . 00 . 00
Grand Total 164 . 80 164 . 80 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH 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: �Wyf11141_ArIAJ/i /22// Permit Number: J2 - 7= �
Legal DescriptionParcel#
Z Q D
Floor Area o q. t. q. t
Valuation of Work$__ 2, O Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)((circle one): "eomrcieeone):
Residential
If an existing structure,is a fire sprinkler system insta Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed:
Property Owner Information:
Name: Address: /520
City State Zip .2 Phone 90 77,= VVZV
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ,Di96z-1_ 2OOIIA4� 1_'o1z1P Al Y Qualifying Agent: /e /fid
Address: � Si'8 �/l/�oaJ -5-7- City��4�"�oPdylt�E State �G Zip 3�'2 i
Office Phone CJS/ '7�/- 25 Job Site/Contact Number Fax#
State Certification/Registration# GGC." 05FIe,9
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 cert 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 of work is not commenced within six(6)months, or if construction or work is susppended or abandoned for a__pperiod ofsix )months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, urnaces,Boilers,Healers,
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.
I hereby certify that 1 have read and examined this plication 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 s eca ted herein or not. The granting of a permit does not presume to gave authority to violate or cancel the
provisions of any other state, or to l regulat'ng construction or the performance of construction.
Signature of Owner X �v Signature of Contractor "
Pant Name
q,ry0 ��1 Print Name ✓� i�j tlJ
�. . .. %: .. lT......��+ h..._ ........._............I..........................
Swo and subs ed befor me Z.Q' rZ! Sworn to and subscribed before me
this M Day of r 2 CO this /7 Day of ,e✓6 vs'T ,20 l 2-
Notary
Notary Public l�
Pub
'+4j
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. s _ it/S -? Tax Folio No.
State of County of d✓�
To whom it may concern:
The undersigned hereby Informs you that improvements will be made to certain real property,and In
accordance with Section 793 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:
General description of improvements: c
Owner /yir'� //✓!/G "T6�t �75� LTA
Address
�a
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address >
Contractor
Address— J!/� 7�✓/Z/ZOli/ S/ S� SO'ot)t/i" m
r 1 { 44E mac_ Z Z/-7 a
Phone No. �i O-f Fax No. l'o y 7.�3 ZZ�jf' Ov
Surety(f any) $' a-
00r
Address Amount of bond 6
Phone No. m o
Fax No. tY m U
a _NY S
Name and address of any person making a loan for the construction of the improvements. U
UJ
Name ^N
Address N DO)
Phone No. w
Fax No. IDUIt LL
Name of person within the State of Florida,other than himself,designated b owner u n°z rr
9 Y upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone 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 /O R
this day°r in
.:s �.•.•... I rya ,. a0Yapp-red 1r V��a'�4'
•0•e are true and and affirms that all sta and dedaratiom herein
acIn b
curate
r
o =
.o �u NoterY Public at Large qourityci t v�
W canndsslon expi
Personally Kna:m
Produced Identification °r