Permit Reroof 1902 N Sherry Dr 2012 . � CITY OF ATLANTIC BEACH
, s 800 SEMINOLE ROAD
=" ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
f it
Application Number . . . . . 12-00001537 Date 10/19/12
Property Address . . . . . . 1902 N SHERRY DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 12000
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Application desc
REROOF EXHISTING
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Owner Contractor
------------------------ ------------------------
PETERS, DONALD E SCHULTZ ROOFING COMPANY INC
1902 NORTH SHERRY DR 216 N. 20TH STREET
ATLANTIC BEACH FL 322334520 JAX BEACH FL 32250
(904) 246-2315
-- Structure Information 000 000 REROOF
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Permit . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 110 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 12000
Expiration Date . . 4/17/13
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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 110 . 00 110 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 114 . 00 114 . 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: Permit Number:
Legal Description � o� �.5" Parcel# v�0,:;0'0
Valuation of Work S_ 1 Z, oc:o Proposed Work heated/cooled ', _
non-heated/cooled
Class of Work(circle one): New Addition Alteration P
Move Demolition Pool/spa window/door
Use of existing/proposed structure(q)(circle one): Commercial si en
If an existing structure,is a fire sprinklersystern installed?(Circle one): o N/A
Florida Product Approval F► SYYy, t >7w-<go Pei STi ce-
For multiple products use product approva orm Fl. 10450,-19-2-
Describe
9zDescribe in detail the type of work to be performed:_ N rua r-
0)0 1 �1�1/1L.IPS CSL�+ C-'
Prous t��y77��Owner Informatio
Name:N�agW, -�5. Addres • f-
ci3 T7
E-Mail or Fax#(Optional) Statei—Phone
Contractor Information•
Company Name: Schultz Roofing Co.,Inc. Qualifying Agent: Douglas A. Schultz
Address:216 N 20''St City Jacksonville Beach,Fl. 32250
Office Phone 904-246-2315 Job Site/Contact Number 759-0063 Fax#904-247-3808
State Certification/Registration# CCC036989
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
isPuancejof a p rint nd that allbwork w berpe>fo med tooin he sta lnda dssof all�aws regulating orhtsa tion:n this utrilsldtcttno as hes FeYmit beP omes ntuh
and void t work is not commenced within szx(6�months, orconstnrction or work is suspended or abandoned for aperrod ofsix(6J months at any time a ter
work is commenced. I rutderstand that separate per
must be secrved for ElechdeaC ATor1S Plumbing,Signs, Wells,Paols, Furnaces,Boilers,Hewers,
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 YOUW NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this a plication and know the same to be mre and correct. All provisions of laws and ordinances governing this
type.)j work will be complied with whether sppec/red 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 low regulating construction or the perforrorance ofconstnrction.
Signature of Owner, > � Signature of Contractor
inPhhb liame -@T
g4!! _........x................................
.................................................
...
Sworno and subscrib f re me Sworn to and subsc ' ore me
this Day of 2(3,[ this Day of 20/a
Notary bl is =: ,' MY COMMISSION#EE 001736
�� ., '1 EXPIRES:August 25,2014 .r 1CMY COMMISSION#EE 001736
P5�Zj /' Bond hru Notary f�ublk Unrerwriterst EXPIRES.August 25 2014
J 'a'�r ' Banded 7hru Notary Public+In R4:.Wised 01.26.i 0
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 1 d '
State of ori a County of
To whom it may concern:
The undersigned hereby Informs you that improvements will be made to certain real property,and to
accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: SZ 44 ,r
71
Address of property being improved:
General description of improvements: �
Owner
Address
Owner's interest in site of the improvem nt
Fee Simple Titleholder(if other than owner)
Name
Address _
Contractor Douglas A. Schultz/Schultz Roofing Co., Inc. CCC-036989
216 North 20th Street Jacksonville Beach, Florida 32250
f Address 904-247-3808
Phone No. 904-246-2315 Fax No.
Surety(if any)
Address Amount of bond$
Phone No. Fax No.
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
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 001j,ER, ,..�
9 8 . .a