309 Belvedere St roof 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . 12-00001669 Date 11/08/12
Property Address . . . . . . 309 BELVEDERE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9394
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Application desc
reroof
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Owner Contractor
-
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STERN ELIZABETH GOLDEN ROOFING INC
309 BELVEDERE ST 2036 SEAHAWK CIR
ATLANTIC BEACH FL 322334110 PONTE VEDRA BCH FL 32082
(904) 885-3369
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Permit . . . . . . ROOF PERMIT
Additional desc .
Permit Fee . . . . 100 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 9394
Expiration Date . . 5/07/13
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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 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 104 . 00 104 . 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: 3Dq 13e.1uc�•_ r� S� R�frA4;C Permit Number:
Legal Description - - - a E SEG S LT Parcel# '_7042S -0220
Floor Area o — Sq.Ft. Sq.Ft
Valuation of Work$ '�9�1. 9`3 Proposed Work heated/cooled non-heated/cooled 3
�L(ZvoF
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):, Commercial esid ' 1
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval# FL;;KLIH A
For multiple products use product approvalCorm
Describe in detail the type of work to be performed: Rpt u aenA
Property Owner Information:
Name: —1i Address: 3�09 13a)velcsL S t. Abcv i
City I State LZip Phone lt) g �` 9G�49
E-Mail or Fax#(Optional-
Contractor Information:
Company Name: G-ol& am Quali g Agent:
Address: qti City u t sonv�!►t State E_ Zip -�a5G_
Office Phone 0-0300 Job Site/Contact Nurnber aoy-7S5--70-7 Fax# L70q --45t3- Y9�
State CertificatioAegistration
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. 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
and void if 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 separate permits must be secured for Electrical Work,Plumbing,signs, ells,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 YOUk NOTICE OF
COMMENCEMENT.
I hereb 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 p work will be complied with whether sppeci zed 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 1 law regulating construction or the performance of construction.
J
Signature of Owne Signature of Contractor p=-�----
f
Print Name Print Name llM.(e........ M 5...._..................._............
1... ..................... .......
.. ........... ,� _....
A.
Sworn tmnd subseried before me Sworn and subscribedbefore me
this `b 'Day of ,20/ this Day of 20 /2—
Notary
vNotary Public a,,n,?y,,,,, rr Notary Pull c
y , "a, r < e '• 9 Expires 3WMW( 1.26.10
Florida Notary Assn.,Inc
111414 all Yul■aY1Y�■YY,Y�ir1Y■Yuu■t,uu.■■a
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legal description of roperty and address if available):
2. General Description of improvements:
Q��Q���
3. Owner Information:
a)Name and Address: E zr�r Scs,r A+1,4 i� fz u c�l r: L 3x23
b)Interest in property:
c)Name and address of simple titleholder(if other than owner):
�}4. Contractor Information:
p a)Name and Address: GAdA(.6445,,Ir6 %.�G• — 9#?/13.*y job Y&S A( s,/o4 — 3,94-f16
b)Phone Number: -"66
5. Surety Information: /
a)Name and Address: Doc#2012251699,OR 6K 16137 Page 1880,
b)Phone Number: Number Pages:1
c Amount of Bond: $ Recorded 11108/2012 at 03:04 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
6. Lender Information: RECORDING$10.00
a)Name and Address: /I/�J(
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7,Flor'da Statutes:
a)Name and Address: Al
b)Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive a
copy of the Lienor's Notice as provided in Section 713.13 (1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner:
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from the date of recording unless a different date is
specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated
therei a true to t of my knowledge and belief.
Signa of Own o Owner's Authorized Officer/Director/Partner/Manager Signatory's Printed Name&Title/Office
The foregoing instrument was acknowledged before me thisZ/ --�day of
as for
(Name of Person) (Type of Authority,i.e.Officer/Attorney) (Nam arty Instrument was Executed for)
WILLIAM E 'R BLIC, STATE
=LORIDA
� WILLIAM E.
.���.N'YP ,1V E@ft
L �� � Fbridal j Known
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Revised 10/1/2010