Permit Roof 631 Sherry Dr 2013 ` CITY OF ATLANTIC BEACH
r 1 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . 13-00001949 Date 1/07/13
Property Address . . . . 631 SHERRY DR
Application type description ROOF PERMIT
Property Zoning . . . . . TO BE UPDATED
Application valuation . . 6900
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Application desc
reroof
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Owner Contractor
-----------------------7 ------------------------
RAMSAY, ELISABETH B GREAT WHITE CONSTRUCTION INC
631 SHERRY DR 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FLI32233 JACKSONVILLE FL 32216
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Permit . . . . . . ROOF PERMIT
Additional desc
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6900
Expiration Date . . 17/06/13
----------------------------7-----------------------------------------------
Other Fees . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- -----j----- ---------- ---------- ----------
Permit Fee Total 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 189 . 00 89 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Permit number • Tax Folio number
NOTICE OF COMMENCEMENT
STATE OF FLORIDA
COUNTY OF
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real
property, and in accordance with Chapter 713, Florida Statutes, the following information is
provided in this Notice of Commencement.
1. Description of property:
2. General description of improvements:
V-A"v c(
3. Owner information:
a. Name and Address:
b. Interest in property:
C. Name and address of fee simple titleholder(other than owner):
k
4. Contractor's name and address: < i ti_ �1 .: c•, `�-- .G ��z _-� t=` 2 ►{;,
a a. Phone number: 1��1 b. Fax number:
5. Surety information:
a. Name and address:
b. Phone number: c. Fax number: d.Amount of bond:
6. Lender's name and address:
a. Phone number: b. Fax number:
7. Person within the State of Florida'designed by owner upon whom notices or other documents
maybe served as provided by 713.12(1)(a), Florida Statues.
Name and Address:
a. Phone number: b. Fax number:
8. In addition to lumself/herself, owner designates
of to receive a copy of the
Lienor's Notice asprovided u�Section 713.12(1)(b), Florida Statutes.
> 9:'' Expiration date of Notice of commencement (the expiration date is one (1) year from the
Z) date of Reco.rduug—iO&ss a dgerent date is specified) -`'T`
�O +f
Signature of Owner
aSworn to and subscribed before nae this day of �....
20
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ori _ w o Notary: j aolhar n�B�c TRAVIS&AUGF M
* * EXPIRES:January 22,2016
M m n W Known personally/ID.shown: Bonded NOjq senke6
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O U-_1
E p w My commission expires:
es:
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: Ce 31 Permit Number:
Legal Description,_�D-r4-'�- Parcel#
Floor Area o . t. q.Ft
Valuation of Work$ �qoc� 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/pro osed 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# 4 or ay , l(a
For multiple products use product approval arm
Describe in detail the type of work to be performed: mAaDt
Property Owner Information:
Name: Address: Wk Shcr�`i_ - NSL2 k 9zz3R
City State T�L.Zipalk �Phone 9oq
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: (';A-m,k Cx� lcv.Ac - Qualifying Agent: " r-c,-:s "�la.�►�-
Address: �,L City^tom State t-L Zip
Office Phone `I t l 9 3%-16" Job Site/Contact Number Fax#
State Certification/Registration# &vTnq77 _
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 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. I understand 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.
I hereb 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 ojYwork will be complied with whether specified herein or not. The granting of a permit does not presume to gave 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 �'2,� .r Print Name = S ` ��
........�.G.................. .... -5ca...................... .... .....................................�� '''...................................................................
Before me B ore me
this Day of 'Tiwiz." _3 _ g . ,,..F. 20
HA
MY COMMISSION 1 EE 162194 j )1i__
Nlk(PIRES:January 22,2016 .. ,r,oac Ua�9e Writers
� O"x.f Bor"Than Budget Notary Seivicea " ` - Revised 10.24.12