Permit Roof 1644 Park Terrace E 2012 CITY OF ATLANTIC BEACH
1 ) 800 SEMINOLE ROAD
`-> ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 12-00001721 Date 11/20/12
Property Address . . . . . . 1644 E PARK TER
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF LRG-LOT DISTRICT
Application valuation . . . . 15000
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Application desc
NEW ROOF
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Owner Contractor
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COKER, ALEX B & MARSHA L SCHULTZ ROOFING COMPANY INC
206 MARGARET ST 216 N. 20TH STREET
NEPTUNE BEACH FL 32266 JAX BEACH FL 32250
(904) 246-2315
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Permit . . . . . . ROOF PERMIT
Additional desc . . NEW ROOF
Permit Fee . . . . 130 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 15000
Expiration Date . . 5/19/13
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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 130 . 00 130 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 134 . 00 134 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION �a'
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904) 247-5845 I
Job Address: zn/� j n� C� Permit Number:
Legal Description ' .� g A C� /J/ 4Parcel
Valuation of Work$ 15r 000 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): <f ew 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# Oniml F - fLLG Po i y 5t6U4- T7V-vX 6
For multiple products use product approval form In)jC--- FL15qq q- P-14 Ce24r,,^4--e-,e,, LOn� AfIZ-
Describe in detail the type of work to be performed: roti -F- Ne uJ ()NSA 0'V r t ont
Property Owner Information:
Name: /�2 V
City �State�Zip�� Phone
E-Mail r Fax#(Optional)
Contractor Information:
Company NameUjj2 L �r Quali ing Agent: / - U�TN
Address:, /�e C�. Cig(-7 ,1/�_ �j_State CG Zip
Office Phon Job Site/Contact Number Vie,! l;o -� Fax
State Certification/Registration#_ 192(2- d1&6 �9
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. 1 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 of work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperaod ofsix(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrleal Work, Plumbrfng,SJgns, We11s,Pools, Furnaces, Bolleis, 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.
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 o1 work will be complied with whether specified 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.
Signature of Owner Signature of Contractor.
Print Name f. .G.,.... � Print Name i 1
Sworo to and subscr!be fo me Sworn to and subscrib bef re me
this�Day of ,2049 this 3/ Day of t� 201A
otary Public o
+'t ROSAuiVU -' --�
*= MY COMMISSION#EE tX),1 36 ROSALIND CLARK
EXPIRES:/lugu&25,<,uI4 f MY COMMISSION#EE OOTl9cvi d 01.26.10
Rf,s10' Bonded Thru Notary f un?.c,+n(mtwriim =y. o, EXPIRES:August 25,2014
JJJ 7, Bonded Thru Notary Public Underwriters
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uvc it culcioDZUi , VA tsn lovcz rage 4zo, Nunwer rages: i, necvraea uo/u.�/cult
at 02:38 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
State of rLo a;y A Tax Folio No. f'77-02 - 403 OC
County of Di)VA 1,
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:
L9)T 2 3Lor-/k i SELVA 1Vt/34Z.M 1A 04177 7
Address of property being improved: It,4 FAA 14 T E AAAGE EAST -
General description of improvements: N E"j Yom E,
Owner:hzx A. 'i` MAAR•SHA L. Gv/t-r'/1 Address: ZO(,. tMA_j 6Q4Wa_J" Sr 134.0 Ft.
Owner's interest in site of the improvement: Fee ,Vb/NI A l-e 3 ��
Fee Simple Titleholder(if other than owner):_ S AM E
Name:
C ntractor. &-AMe 6r,8 ►�,scT��IJ CoM DA,4 TAC. -
Address: /Z?3 _rAJA`i LwoO 1) aQ IU 'A;a,J� df A
Telephone No.: y'�11-8 8''O`f y 1 Fax No:
Surety(if any) '414
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person malting a loan for the construction of the improvements
Name: //4- --
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: 1,111A
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 OWNAR
Signed: Date: a 5 Z
Beforeday of l in the County of val,State
Of Florida,has personally appeared,
Notary Public at Large,State olFlorida.County of Duval.
WMWAW 111 My commission expires: tiv or
/AN N0" �aP*a. Personally Known:
**EE 174710Q Produced Identification:
1*M"-ft0MFsb.Z8,ZOte ���� e.,r.5 aINI!b