Permit Roof 1825 Live Oak Ln 2013 ` CITY OF ATLANTIC BEACH
'� s) 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
N h
Application Number . III, 13-00001950 Date 1/07/13
Property Address . . . . 1825 LIVE OAK LN
Application type descri tion ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . 14282
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Application desc
reroof
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Owner Contractor
-----------------------4 ---- -------------------
PENDLETON RONALD L HAGERTY CONSTR. AND ROOFING
1825 LIVE OAK LANE 3749 QUINBY ISLAND CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 819-5545
----------------------------1--
Permit . . . . . . R06F PERMIT
Additional desc
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 14282
Expiration Date . . 17/06/13
---------------------------- -----------------------------------------------
Other Fees ! . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------- -----------------------------------------------
Fee summary Char ed Paid Credited Due
Permit Fee Total 25 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 29 . 00 129 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE NINTH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPIACA'TION
CrrY of ATLANTIC BEA.CO
800 Seminole Road,Atlantic.Beack FL 32233
Office(?04)247-5826 Fax(904)247-5845
Job Address: g Permit Number:
Legal Description 10- Parcel# 14 Z Z
Fro—or Area Valuation of Work S L.00 Proposed Work heated/cooled 1q,
Work
q,LDt� OL 'tt s 6L u*?.rS
Class of Work(cirde one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of Vdx ng/pro ,stracture(s)(dude one I: Commercial Residential
If an existing re,>u a fire sprinkler installed?(Girds one)• o N/A
Florida Product Approval#�r. . 1 0 k)bmLA T V49Ay''�
For multiple products use product approval-form
Describe in detail the type of work to be performed: N-
- Lz` -ku
Property Owner laformation:
Name:NIA 1"Lle
Address: W UK tAe LAI a.• $4 . r-L. JIL33
City 6&LA N7LL Sfiatej_L2;ip JVA A Phone e'4• 1-4cp • -1410
E-Mail or Fax#(Optional)
Conhuctor Information:
Company Name: }k uC 1)K) TLOW t 46 Qualifying Agent: )t KL J . AA CEV
Address: City cJAj jdS .Uxtxj� StateF;i_ —Zips z A
Office Phone Job Site/PontactNumber Q( M1. A&M Fax# C164. CQL• 4q(01
State Certification/Registration# CLC 0
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Apptraatiort is hereby Horde to o�ain a permit to do the work irrstallatiorts as indicated I certify that no work or irrstalladon has commenced prior to the
lasruarrrea perm#cad that all wank will be peormed to the atarrdarda of all laws negulatg consbvr in
awnodrk.nisid comwmantnkciesd not tcaunndmeernatcaerdrd wthitahtin seapfxara(6tempoerrrmtlr�itsar be secro�edfa�r wEolrakafbsia�otr Worlr,ParlrwaiLta6rhatdgo,aSedY�gfir�s, hisjursdilorL This permiNcomes mull
WwPoofoossixFr)»maihsBsey;tg
TanktattdAlrCotrtgUaeary etc -
WARNING TO OWNER: OUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESUL IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU ND TO OBTAIN FINANCING CONSULT WM
YOUR LENDER OR AN ATTO Y BEFORE RECORDING YOiN NOTICE OF
COMMENCEMENT.
I hereby cert3 fy that I have mad and crammed this licadon Anow the samd to be true and camp All provisions oflaws and ordfnaaces governing this
type of work wfJl ba eomp/ied with whether her+efn tort. The granting of a permit dots not pnsYnte to authority to violate or cancel the
provistars of :wne otherjeor local aw regulating n or the performanceof cortsia�tcttonSignature of �'`' �` -- Signature of Con r
Print Name `m K, E" D"..:MLL Print Name
Sworn to and subscribed before me Sworn to and subscribed befo me
this TL Day of 20 Z this 2-1,Day of 20 L
NotaryPublic rr-- • TIFFANY tiARDNE
! ANIf"t3A R ?- MrcoMMlss". 26.10
"t '? MY COMMISSION 8 E 19875 ���
EXPIRES August 06. 018 EXPIRES August 06.2016
` 407 396C1S3 �bnCallov min
407 30"153 FWdDN
NOTICE OF COMMENCEWNT
Shue of f!,1D ADA= Tax Folio No.
County of b U\ *L
To Whom R May Concern:
The undersigned hoarby informs you that unproveme*will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is afided in this NOTICE OF COMMENCEMENT_
Legal Description of property being improved
LOT J. 1L - tr
Address of property being improved
General description of improvements: &I EW R tj SAALGLED
0
. word
Owner._ILDISA I&1�.5 DL.E"rr') Address: JUS-- LI u E- b A f( L a±s�E
Owner's inter in site of the iroprovenient
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 1 r
Address: I Zli V 11 A N nagjk f�i V �Z. �1�t'�QI�I LQ � T'L. .
Telephone No.: q0q, Qq'L• qg, u® Fax No: got{ macMq Z.• �tC((e L
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: FaxNo:
Name of person within the State of Florida,other than himwit 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 VWNF.R
igned;%LL,, G ., Dat,.X
Before me this Z Z day of Dt.��dt in the County of Duval,State
Doc#2013004311,OR BK 1620 Page 173, (Monte�p�nally - — '
Number Pages:1 1�otary Public at Large,State f County of l
Recorded 01iNi2013 at 10:26 AM, y Commission expires: Y
J!M FULLER CLERK CIRCUIT COURT DUVAL I ersonallyKnown: or
IDA
COUNTYced Identification:
RECORDING$10.00
MY COMMISSION#EE219WO
EXPIRES August OIL 2016
107s�e^otss FloRe.N .ran