700 Amberjack Ln roof 2012 CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001677 Date 11/13/12
Property Address . . . . . . 700 AMBERJACK LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4200
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Application desc
reroof
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Owner Contractor
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FORE, FRANCIS HOMEOWNER BLDG SVCS INC (ROOF)
700 AMBERJACK LANE 739 BROOKMONT AVE E
ATLANTIC BEACH FL 322334202 JACKSONVILLE FL 32211
(907) 322-1054
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . Valuation . . . . 4200
Expiration Date . . 5/12/13
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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.
uuir,>vilvtJ r r.nivii it r%rrui%_A i ivi,4
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 17M ,&A 1i3F✓tjcac l' Permit Number:
Legal Description3DYocp 3%-2_6-2_q F.19 QAXAcP m !4mij I Parcel #
�( Floor Area of Sq.Ft. Sq. t
Valuation of Work 0a 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 fir sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # L /0 / Z Ll -
For multiple products use product approval form
Describe in detail the type of work to be performed: QE 20.0 F'
Property Owner Information:
Name: Ct9 'F0(LE Address:
City AjLgKn1[ U�014 Stater—Zip 22 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 14#W LIEU&II14101-4- AULUBs Qualifying Agent:
Address: 7-39 Rbolt Maty+ Auf it City_&arttSa.Jult_t_re— State fL Zip-A221 I
Office Phone 4oy-AZZ-10 8V Job Site/Contact Number Fax#
State Certification/Registration#
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 ivork 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 pet formed to meet the standards qf all lams 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 apperiod o1 six(6)months cut ani,time after
work is commenced. I understand that separate permits must be secured for Electrical{fork, Plumbing.Signs, 1Vells, Pdols, Furnaces, Boilers, Heaiers,
Tanks and Air Cont6lioners,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.
1 hereby certify that 1 have read and examined this applicaiion and know lite same to be true and correct. All provisions of laws and ordinances governing this
type of work ivill be complied with ►yhether spPecijted herein or not. T he granting of a permit does not presume to give thorny to violate or cancel the
provisions of anv other federal.state.or local ta11,regulating construction or the per/armance qJ constntciion.
,Signature of Owner Signature of Contractor
Print Name c._`...._........_.'FC7 ce Print Name .....!!�
...a..r..... S ........................................................ ���- . 1.....1 ........... k.............�Oz _ ....
Before me Be f me
this th Dav of 0Mt 0-f . ')010— t s D of 20
L.GRAHAM
'Nota P tic ary
tq.• _ ,;- F MES:February 14,2014
8�led ru Notary? li t
CINDIE HERNANDEZ - 6.10
MY COMMISSION#EE148600
EXPIRES.Novm ba 27,2015
Y FI NNan Discount Assoc.Co.
1-804J-NOTAR
NOTICE OF COMMENCEMENT
State of RL #",Ow/% Tax Folio No. �� 1! Z. 1"—c.�D 0 G
County of 17C-t Ws,,..t
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: W-tot-2 L,- ``i V 19 2 C,149,1- _j," �Y1-S a..s L 4 I
Address of property being improved: '. r')
General description of improvements: " 'lit, ' :3--22A
{�
Owner: �=y� �-�. '� Address.. 4
Owner's interest in site of the improvement: 'VEF .51IVNPI
Fee Simple Titleholder(if other than owner):
Name:
Contractor: �J4NRiii. a' •i so--fit+- 5�•ti!1 E�'re
Address: t%3"5 kai�A� 1t Mait`lCJtzl°-� L
TelephoneNo.: "f C`' °�� Fax No:
Surety(if any) Doc#2012254141,OR BK 16140 Page 2432,
Address: Number Pages: 1
Recorded 11113/2012 at 08:49 AM,
Telephone No: Fax JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Name and address of any person making a loan for the construction RECORDING$10.00
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: �`rt �' �v� ..�= I 2 L
Address: ! r "` �''s r� t k t IA, (" t t ��`7L �!E"_ .�rG 3
33
ti
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: ✓? ��✓ Date: ALI,
Before me this day of t I i e Coun State
CINDIE HERNANDEZ Of Florida,has personally appeared ErlL(-104-L
MY COMMISSION#EE148600 Notary Public at Large,State of Florida,County of Duval.
'� , EXPIRES:Novanb r 27,2015
°"`� FI Not My commission expi
1.800.3•NOiARY ary Discount Assoc.Co.
Personally Known: or
Produced Identification:
r