Permit ReRoof 369 Royal Palms Dr 2012 'i CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r j
w ATLANTIC BEACH FL 32233
. INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001701 Date 11/14/12
Property Address . . . . . . 369 ROYAL PALMS DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9760
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Application desc
REPLACE ROOF
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Owner Contractor
------------------------ ------------------------
BATTS, HENRY JR TIER 1 CONSTRUCTION (ROOF)
369 ROYAL PALMS DRIVE 13245 ATLANTIC BLVD STE 4-212
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 610-7979
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 9760
Expiration Date . . 5/13/13
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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 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: �°`� Pyy c'k P4 V- -5 (Z Permit Number:
--- P0y, PfA � NA`T 2A,
Legal Description '� —of �4 34S 2� — '�`t� ofPTp arcel
# l?/
�, oor Area o q. t. Sq.pt
Valuation of Work $ �17(to Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) (circle one): Commerci Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # G- (L(P 7 q^ P (p
For multiple products use product approval form
Describe in detail the type of work to be performed: F - Poo P I V-, LA
Property Owner Information:
Name: _k6AQN AID> Address: '3 (acl (2q4tk l ?,0 L.4—S P4
City <1'f t.rA✓ -t G 13 e 0 State FLZip 3 7-1273 Phone Ci
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: �i2 C-�� �2ve;TL Qualifying Agent: 134."t' P a-i S
Address: 32.E r 1iLA✓t G v ) City J A- c..9 0.1 vt 112 State fig- Zip 3 7,2'L.
Office Phone Y- Rte(b ^005 4 Job Site/Contact Number cx t:l ol 7 77 Fax# qe q^ 2°f&-oo 9/
State Certification/Registration# CCC. i 2; 0 T
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
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 abandoned for a period of six(6) months at any time after
work is commenced. 1 in 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.
1here
b,certify that 1 have read and examined this a lication 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 speci ced 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 law regulating construction or the performance of construction.
F
Signature of Owner Signature of Contractor
Print Name � ��/A- 5................................................................ Print Name �j ....... ....�9-L�.11 l l�►...........................
Sworn to and subscr' ed before me Sworn ttjand subscribed before me
this y of ��_ ,20 Z_ this /S' Day of 20 (2-
Notary'P blic RENT PA I
K
4JINi
ry ublic,State of Florida Publio,State of Florida
My Comm.Expires May 14,2018mmission#EE 49709Revised 01.26.10
Commission No.EE 198158m.expires Doe 1t1,2014
NOTICE OF COMMENCEMENT
State of E Tax Folio No.
County of - Q"/C,j
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: 3-1 t11 LC 3 ? ^ 2 5 -- -Z C,
Q•j P OF K 0E 1t V1, eL 1 PA,(_vI-`, 4!n�t 1 2 A
Address of property being improved: n ,fj JP4 L, g {?e,L i
General description of improvements: '' 2 ve
Owner: I- ,�Q;, �r}'( Address: It PC .44 P-41 "LS Da
Owner's interest in site of the improvement: PIZ\-4-A-4-1
Fee Simple Titleholder(if other than owner):
Name:
Contractor: `T TV?,
\:;Address: 1.3 Zit A=1 Lr4-r1 Ti C. 1�'�1.'N� �JA_e-tt5 �'r✓ ZL 3 Z Z 2
Telephone No.: l�'t/' Z �f 4� ^Ci(?4 Fax No:
Surety(if any)_
Address: Amount of Bond$
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
Signed: __Pate: Z
Before me -: a� r`.u �-� in the'County f Duval,State
Of Florida,has personally appeared
lotary Public at Large,State of Florida,Co my of Duval.
Doc#2012256449,OR BK 16144 Page 95, 1y commission expires:��1 It/ Z t"i l&
Number Pages:1 Known:nown: r,,-
Recorded 11i14r2012 at 02:07 PM, ersonao or
JIM FULLER CLERK CIRCUIT COURT DUVAL roduced Identification: BRENT PARRISH
COUNTY Notary Public,State of Parids
RECORDING$10.00 My Comm.Expires May 14,2016
Commission No.EE 196158