Permit Roof 1712 Sea Oats Dr 2012 `SS CITY OF ATLANTIC BEACH
r s1 800 SEMINOLE ROAD
J = ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
VA
Application Number . . . . . 12-00001498 Date 10/11/12
Property Address . . . . . . 1712 SEA OATS DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
ReRoof
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Owner Contractor
SHIMSHONI, MOSHE CHAMPION ROOFING SERVICES INC
1712 SEA OATS DR 3734 SPRING PARK ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 396-4642
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/09/13
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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
N
i,� CITY OF ATLANTIC BEACH
0
r 800 Seminole Road, Atlantic Beach, FL 32233
r" Office (904) 247-5826 Fax (904)247-5845
Job Address: i f` �GL /��%�'� Permit Number:
Legal Descriptiono CQ
Floor Area o q. t, q, t
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Workcircle one): New A��Alterati
( ) on Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial identia
If an existing structure,is a fire sprinkler system installed? (Circle one : es No /A
Florida Product Approval # FL. 1012q-. I
! For multiple products use productapp— rovatlorm
€it
'° Describe in detail the type of work to be performed: re f��
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a� Property Owner Information:
f1i Name: of I I Address:
., City Stat �ip Phone
a E-Mail or Fax# (Optional)
ContractorInformation: e6kff1WCompanyName: /�Ylr 5 Quali g Agent: � S ���•�
^address: Gw1C City State Zi
Office Phone Job Site/ �,o act-Number D Fax#WV,��Ilo
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
t
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
to
and void�f 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. I understand that s
Tanks and Air Conditioners,etc. eparate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
y
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
r, TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
lI YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
- COMMENCEMENT.
A.
t19 Thereby 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 o work will be complied with whether speci ied herein or not. The granting of a permit does not presume to give authori to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of g �� `� `�"Signature of Contractor
Print Name .. .. �. -�.......................... Print Name...:...... . ...... ........ .....U.l 1.�.
'! Sw n subs ri ore me Swo nd subs before me
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thisYF I OF FLORIDA 20 this Tay of 20
Conlq ssioo#DD926176 IdOTARY',PUHI.tC•STA.T
, OF FLORIDA
Notary P. ' Rfli;A;7dRnCBON MGCO.,ngc Notary , Co �i3�ok!#DD926176
V1..,;,..,,•'Exp i sq'17,2013
l BONDEnra:i,: ��ncli ::nAGco ised 01.26.
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Doc # 2012222096, OR BK 16100 Page 67, Number Pages: 1, Recorded 10/10/2012
at 12:57 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
t
NOTICE OF COMMENCEMENT
r+ (PREPARE IN DUPLICATE)
j Permit Tax Folio No.
tli State off County of
To whom►k y concem �
The undersigned hereby Informs you that Improvements will be made to certain real property,and in
accordance with Section 719 of the Florida Statute*,the following Information Is stated In this NOTICE OF
011' COMMENCEMENT,
I+ Legal dlwpiptlon of prop-pay prop-paybeing improved; Com ' r
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Address of property being improved:
L
General description of improvements:
P'
r. Owner 4
tli Address
(" Owners interest in site of the i
#i? r►Wrovement
Fee Simple Titleholder(if other than owner)
Name "
Address
til Contractor amp on Roofing :*rVICba,Inc
F$ Address o-nest Otk"
ill Phone No. Gf)41)4qR�fi+�t~ft 45740a `
Surety Of any) HUfnCane.Pronf Rnnfc rnW
r Address Amount of bond ll
Phone No.
' Fax No.
t!f
r14 Name and address of any person making a loan for the cOnatrumon of nee improvernents.
id Name
Address
tl Phone No. Fax No.
Narne of person within the Slate of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Narm
I' Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the LlenOr"s Notice as provided in
fH Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's optlon).
;u
r Name
Address _
.I Phone No. Fax No.
Expiration date of Notice or Commencement(tiro expiration date is one(1)year from the date of recording unless a
different date is spedfled):
TMS SPACE FOR RECOROWS USE ONLY (\
tI� Sinned: DATE. 12-
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=Commission DD926176 61
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Permit Inspections
City of Atlantic Beach
Permit Number: 12-00001498 Description: ReRoof
Applied: Approved: 10/11/2012 Site Address: 1712 SEA OATS DR
Issued: 10/11/2012 Finaled: 5/21/2013 City,State Zip Code:ATLANTIC BEACH, FL 32233
Status: FINALED Applicant: <NONE>
Parent Permit: Owner: MOSHE SHIMSHONI
Parent Project: Contractor: CHAMPION ROOFING SERVICES INC
Details:
LIST OF •
SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS
ID
10/12/2012 10/12/2012 BD ROOF DRY IN Mike Jones APPROVED
Notes:
am
5/21/2013 1 5/21/2013 BD ROOF FINAL I Mike Jones I APPROVED
Notes:
s
Printed: Friday,06 September, 2019 1 of 1 �