Permit Roof 456 Irex Rd 2012 L CITY OF ATLANTIC BEACH
"~ 800 SEMINOLE ROAD
}
ATLANTIC BEACH, FL 32233
t
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001562 Date 10/24/12
Property Address . . . . . . 456 IREX RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4975
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Application desc
reroof
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Owner Contractor
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CORNERSTONE HOMES LLC QUALITY DISCOUNT ROOFING LLC
8323 RAMONA BLVD W STE 6 1794 ROGERO ROAD
JACKSONVILLE FL 32221 JACKSONVILLE FL 32211
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4975
Expiration Date . . 4/22/13
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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 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No
State of r,,,r"aa County of ",a ,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: 1.-
a 'o; 7
General description of improvements:
Owner(
Address fr` �� 1y hit1��1� �ti ��� �� ' f 1� 1
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor "d w t�.. r_$ ' I V0
ri1 ri
Address a"��� �_�r � i:� kA, �St`.t°� `" "��;- .a 'b l
Phone No ,`' d it >u.: Fax No
Surety(if any)
Address.-.-.t""`/s' Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name A/c A E,,°l _.
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 o N N
different date is specified): Cc
0
`o �Co�
THIS SPACE FOR RECORDER'S USE ONLY NER > 07
Befor w », 14�2hr in thhee• W a X H
Doc#2012236335,OR BK 16116 Page 1975, Cou of Duval: of F a ,ha;pprsonell ared
Number Pages:1 W;, t... herein by = a E E
himsefli hersed and afArms that ali statements and declarations herein
Recorded 10/24/2012 at 02:29 PM. are true and accurate
JIM FULLER CLERK CIRCUIT COURT DUVAL ; z
COUNTY
RECORDING$10.00 ,
Notary Public at ryf Lerg®<S e of oun os " LL°
My commission expire`" .r
PersonallyKnmug or �'�•; Via•
Pro„yuced"entficahort- L x"
auu
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 9; O T(LV J. Ai6fiL &ch 232 3 Permit Number:
Legal Description 3 i -u to, 3�34S-,4� E Parcel# I ') r 2S-®t JG
_�� Floor Area o q, t. ` q, t
Valuation of Work$ Proposed Work heated/cooled 12-2-C) non-heated/cooled
Class of Work(circle one): New Addition Alte atio � Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercialid4- of n!
all
If an existing structure,is a fire sprinkler system insted? (Circle one): es No
Florida Product Approval# 2.
For multiple products use product approw-afffomm
Describe in detail the type of work to be performed:gernow, L kw j d aiho t F Liu &,I dt k
PLO)aw- wi+h ire ,' Afi4 LST S,iginqkS. 23--sq-.s. �i Z tits lob
Property Owner Information:
Name: Address: U L 1C C7i�1L Kt _ )L—L -31 (—
City 4 ooes,,:ya,j, ( I.e,. State&Zip 3 12 1 Phone 6100- 18b—
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: t t a<ia LiC Qkm no-(�nck 11�� Qualifying Agent:�Y
Address: 11A u Q.��,� p3City;Jccc oWi L(-eState rc Zip AZZA
Office Phone 924- Job Site/Contact Number 01 a4-4(e-I-(C fp Fax# V,(0�0-3ft-(0(._
State Certification/Registration# C CL t 3 ZG rrIP1.5
Architect Name&Phone#
Engineer's Name&Phone# h /
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address /UC) �Xj E
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
ssuance 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 if work is not commenced within six(6)months, or if construction!or work is suspended or abundoned for o e . d cl'six(5)months.,!i!%T}'`inw ,fr,:r
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces,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.
I hereby certify that I have read and examined this.pplication 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 eci 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,stat ca aw gelating construction or the performance of construction.
A_
Signature of Ow e` Signature of Contractor -7�
Print Name ...............� �i� .................... Print Name . .... .. . ............1�.1.:....... t...... I .............
Swo t and subsc�pe�d b fqr me Swo and sub�V' dethis of d' 20 0; this Day of20
r (
Notary blit o aryis
SHEREE J.AMATO
.�,8�,v'
_ .
Notary Public-State of Florida P"Y''%9�;.,, SHEREE J.AMATO
My Comm.Expires May 1,2015 '��' �°= Notary Public-;State of Florida
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