1763 Ocean Grove Dr 2012 roof CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
s)
J. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number 12-00001715 Date 11/19/12
Property Address . . . . . . 1763 OCEAN GROVE DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8820
----------------------------------------------------
Application desc
REROOF - FL 13164
-------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
HESTERLEE JUSTIN E & KRISTIN N BOHEMIA ROOFING INC
1763 OCEAN GROVE DR 3950 ST ISABEL DR E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32277
(904) 859-3539
-----------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF . 00
Permit Fee 95 . 00 Plan Check Fee .
Issue Date . . . Valuation 8820
Expiration Date . . 5/18/13
---------------------
-----
Other Fees STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 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: 1763 OCEAN GROVE DR, ATLANTIC BEACH, FL 32233 Permit Number:
Legal Description 20/20 09-2S-29E OCEAN GROVE UNIT 2 W 83.34FT LOT 7 Parcel# 169603-0000
�Sg g� y Floor Area o q. t. Sq*Ft
Valuation of Work S Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration epair Move�: es
Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial
If an existing structure,is a fire sprinkler s stem installed? (Circle ono N/A
Florida Product Approval# .216
For multiple products use pro uct approval form
Describe in detail the type of work to be performed:COMPLETE RE-ROOF, REPLACEMENT WITH SHINGLE
C-R 1 i•� '�41)
Property Owner Information:
Name:HESTERLEE JUSTIN E, KRISTIN N Address: 1763 OCEAN GROVE DR
City ATLANTIC BEACH , FL State_Zip 32233 Phone. O` - 6-q
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: BOHEMIA ROOFING CO., INC. Qualifying Agent: IVANA HODULOVA
Address:3950 ST ISABEL DR E City JACKSONVILLE State FL Zip 32277
Office Phone 904-859-3539 Job Site/Contact Number 904-982-2114 Fax# 904-353-2700
State Certification/Registration#CCC 1328464
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 anytime after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, 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 YOUR NOTICE OF
COMMENCEMENT.
I hereb certify that 1 have read and examined this application and know the same to be true and correct. All prov4aust
ances governing this
type o1work will be complied with whether s eci red her or not. The granting of a permit does not presumiolate or cancel the
provisions of any other federal,st te,or local aw regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
K,e.....5�IN h( f7,-1P E,e CEE Print Name '�
Print Name _ .......................................................................................................................
.......................................
Sworq o and subsc i befor me Swor -subs ed before e 20/
this-M Day of tf 20 4�-- th' Day of
' D
Notary Publ' Mio"Pubk-NO of Rofft otary EXPIRES:May 21,sots
Myr Cam.EM"Noir 3.2015 ,��^ I3%AW rnru Notary P'6'2�e� .26.10
CommWoe•E 11�N -w° '
Doc#2012261-154,OR BK 16150 Page 1942,
Number Pages:1
Recorded 11-19.'2012 at 10:20 AM,
NOTICE OF COMMENCEMENT JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
Permit No.
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in'this NOTICE OF COMMENCEMENT.
].Description of property(legal description):
RE#169603-0000 LEGAL:20-20 09-2S-29E OCEAN GROVE UNIT 2 W 83.34FT LOT 7
a)Street(lob)Address: 1763 OCEAN GROVE DR.,ATLANTIC BEACH,FL 32233
2.General description of improvements: COMPLETE RE-ROOF,REPLACEMENT WITH SHINGLE
3.Owner Information HESTERLEE JUSTIN E, KRISTIN N 1763 OCEAN GROVE DR,ATLANTIC BEACH, FL 32233
a)Name and address:
b)Name and address of fee simple titleholder(if other than owner)
c)Interest in property OWNER(S)
4.Contractor Information
BOHEMIA ROOFING CO.,INC. 3950 ST.ISABEL DR E,JACKSONVILLE,FL 32277 CCC13284
64
a)Name and address:
b)Telephone No.:
904-859-3539 Fax No.(Opt.) 904-353-2700
5.Surety Information
a)Name and address:
b)Amount of Bond: Fax No. (Opt.)
c)Telephone No.:
6.Lender
a)Name and address: Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address: Fax No.(Opt.)
b)Telephone No.:
8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(b),Florida Statutes:
a)Name and address: Fax No.(Opt.)
b)Telephone No.:
9.Expiration date of Notice of Commencement(the expiration date is one 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 SECTION TIC713E OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I, ,
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, O CONSULT
COMMENCEMENT.OURER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING OUR NOTICE
STATE OF FLORIDA 10.
COUNTY OF PINELLAS
S#7ure;ofOwner r Owner's AuthorizedOfficer/Director/Partner/7�N N
Print Name T`I
J�11G� � ,20 1� ,by ���•
r�.
The foregoing instrument was acknowledged before me this day of =
k (type of author' y.e. .officer,tru e s K15 IV �'V 11ES�EIE 6 as
attorney in fact)for (name of party on behalf of wh ument wase c )=
V/
Notary Signature ;` H c
Personally Known t/ OR Produced Identification 6
Rig =
Name(print) >�'/� L L'G' l��
Type of Identification Produced OR $ s
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing d the*•
the facts stated in it are true to the best of my knowledge and belief.
e0RMsN0c,msd20I0 Sign ture of Natural Perso Si ning(in line#10.)Above