1809 Tierra Verde Drive ROOF 2012 CITY OF ATLANTIC BEACH
'j 800 SEMINOLE ROAD
;J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
�r
Application Number . . . . . 12-00001507 Date 10/15/12
Property Address . . . . . . 1809 TIERRA VERDE DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8650
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Application desc
reroof
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Owner Contractor
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GROSS, PETER T JOHN GILMORE ROOFING, INC.
1809 TIERRA VERDE DR 11647 GWYNFORD LANE
ATLANTIC BEACH FL 322334527 JACKSONVILLE FL 32223
(904) 880-8044
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 8650
Expiration Date . . 4/13/13
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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 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 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: �� t I -'vIyez V"r(ilc b,�L_,` _ Permit Number:
Legal Description Parcel#
� Floor Area of q. t. Sq.Ft
Valuation of Work$ �J(, Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New AdditionAlteerat o Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 41 es' ential�
If an existing structure,is a fire sprinkler system installed? (Circle one): � es o N/A
Florida Product Approval # 8ey2. /
For multiple products use product approvalTor^m
Describe in detail the type of work to be performed: Re-Rcc i=
Property Owner Information:
Tj
Name: � k-1- L% �SSS Address:
City C .� - State ip Phone
E-Mail or Fax#(Optional)
Contractor Information:
/ t
Company Name: ,A h Vl G ! 0 re Fflol' T)Z�. Quali ing C entr e�t 17 l i ►'W1Cti12
Address: I" J I S U Cl19 City 61C i lu i 1 l E State F C- Zip 3 �
Office Phone C 9 .. C h 64 ( Job Site/ConW Number L 5 5- 1 S S% Fax# C< _(i 3 C
State Certification/Registration# C'57(C-
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 ape rmit and that all work wall be performed 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 suspended or abandoned for a_peraod of six 16)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,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 a plication 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 aed 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-l"ocal law regulating construction or the performance of construction.
Signature of Owner < Signature of Co
Print Name Pei—e— Name
.................................................. ..Pa.S. ..5.................................. .................. ... ... ....... .......c..... ..... ..... .......�C' '.................
Swom_Ap and subscQibed Wore me Sworn to and subscribed before me
this Day of this -15 Day of o irtz- 20 12
VIRGINIA ROSALES
p�.`�= Notary Public•State of Florida CAJ�4 RiG1AR�30N.$R
Notary ublic Nom« •f yComm.Expires don 27,2013 rotary Publi STATE OF FLORIDA
• Commission ti DQ 855419 5 1 4
Bonded Through National Notary Assn. • 6.10
NOTICE OF COMMENCEMENT
State of County of Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
F _ '
r
Address of property being improved:
General description of improvements: pr.
Owner: Address:
Owner's interest in site of the improvement: 4; . ` "o l
Fee Simple Titleholder(if other than owner):
��zContractor:
Name:
jd t
♦ V
Address t i P 8 ! t i 1 9 h i i ; t' i .i f_. ; °2
F ,
Telephone No.:` ,i + i_
f Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:_
Doc#2012225926,OR BK 16104 Page 1722,
Name and address of any person making a loan for the construction of the Number Pages: 1
Recorded 10115.2012 at 10:51 AM,
Name: JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING$10.00
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:
Telephone 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 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:_ Date: `(7 /Z- %L
Before methis (Q` day (— Lin the County of Duval,Stat
Of Florida,has personally appeared P r m
Personally Known: o
Produced Identifi tion:
VIRGINIA ROSALES Notary Public.
;"r°, .`�= Notary Public-State of Florida My commission expir
c : .•_My Comm. Expires Jan 27,2013
Commission #DO 855419
'•r+rnr+"` Bonded Thrcugh Nation"I Wary Assn.