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316 (318) 4th St (roof 2012 ) ai r''vf v CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ±� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001575 Date 10/26/12 Property Address . . . . . . 316 4TH ST Tenant nbr, name . . . . . . 316-318 Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 17300 ---------------------------------------------------------------------------- Application desc REROOF ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HOLMES MARK H LIVING TRUST DAVID MERRITT CONST. CO. (ROOF) 275 BEACH AVE 108 FLORIDA BLVD ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 993-1697 ---------------------------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 140 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 17300 Expiration Date . . 4/24/13 -------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 10 STATE DBPR SURCHARGE 2 . 10 ---------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 140 . 00 140 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 20 4 . 20 . 00 . 00 Grand Total 144 . 20 144 . 20 . 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: q4) S4 Permit Number: Legal Description Parcel# �7 3D D-' Floor o q. t. Sq.11t Valuation of Work$ Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# EI �O l Z`�- / For multiple products use product approval form Describe in detail the type of work to be performed:` Property Owner Information: Name: �� -f� �n�C Address: City a e i State Zip Phone —10 E-Mail or Fax#(Optional) Contractor Information: Company N me: GlV ��I l n 0VIjc-4- ti0 l Qualifyin Agent: ���P�1 SSQ ��✓l / Address: © 514 City State Zip Office Phone 2LSS /t/O C\ Job Site/Contact Number o) - / Fax _ # State Certification/Registration# c 132 5Y1 I°f Architect Name& Phone# Engineer's Name& Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address 9pplicati 7 is hereby made to obtain a permit to do the work and installati?ns as indicated I certify that no work or installation has commenced prior to the issuance of a permit and that al!work will be performed to meet the standarof 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 work is suspended or abandoned for aperiod of six(6)months at ar�v time after work is commenced. I understand that separate permits must be secured for Elect c Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heafers, Tanks and Air Conditioners,eta 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 hereby 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 of work will be complied with whetherspeci ted 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 1 ca my regulating construction or the performance of construction. t Signature of Owner Signature of Contractor Print Name //' ll l� Prin ame A (SJ-q ge v�/ . ....... ..4/..Y.............Wj............................................................. (.!/.(........ ......................................................... ...................................................... Sworn subscribed before me / L wor a d subscribe e -Z thi of D 20 l '1 is ay o 20 GRA t Notary Public o a YPT;fS. ,1,. A2014 DAVID E MERRITT ?h.o. Bo�r 6 lora Notary 11 !i Underwriters : = d 01.26.10 +; M`I conrP.flsslo #DD926677 r xPt^ES September 20.2013 %';aaF. �m (4071398-01" . NOTICE OF COMMENCEMENT State of Tax Folio No. County of 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: -3 hf'— �f Address of property being improved: General description of improvements: Owner. l� K ( �'t E-7 C-5 Address 2 Z 3 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: n _ Contractor: ►.Gt t/i' !�, moi'I' 1 k UG O � Address: t f r Telephone No.: f `� �y Fax No: / Surety(if any) Amount of Bond$ Address: Telephone 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: 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 /mi Signed: �_, Date: t0 ( ' �L---- Before me th sday of C C-f-C, '' _in the Count of Duval,State Of Florida,has personally appeared (fig Doc#2012238221,OR BK 16119 Page 964, Notary Public at Large,State of Florida,County,of Duval. r Number Pages:1 My commission expires: Recorded 10/26/2012 at 09:34 AM, personally Known: . 4- ERR or JIM FULLER CLERK CIRCUIT COURT DUVALproduced Identification: 26677 COUNTY2013 RECORDING$10.00 = �_ _r.',ortember 20, ,,ricnlcom