Permit Roof 515 Sailfish Dr 2013 "f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
!? = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . 13-00002002 Date 1/15/13
Property Address . . . . . . 515 SAILFISH DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5543
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Application desc
reroof
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Owner Contractor
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BROWN, CALVIN H. QUALITY DISCOUNT ROOFING LLC
515 SAILFISH DRIVE 1794 ROGERO ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5543
Expiration Date . . 7/14/13
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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 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No.,, Tax Folio No ,a
State of_: r:,r ,,; County of
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 y being improved:
Address of property being improved:
General description of improvements: `
Owner
Address
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor
old
/ Address _* Y, r y w r
Phone No Fax No. �d �`s
Surety(if any)
Address
Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
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 Am 9 7
Address
Phone 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 Statutes.(Fill in at Owner's option).
Name _
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
Fi_.
different date is specified):THIS SPACE FOR RECORDER'S USE ONLY OWNERSig E - DATE ` l uJ
Bet me is day of r ;:: fn theCounty of Duval. tate of FW' a as pertonaliy ap red herein by w c, w2
h a
himsel}/herself and affirms that alt statements and deciaratlons herein LISA � y
Doc#2'013013254,OR BK 16217 Page 2362, are true and accurate x o- � E
Number Pages: C/)
N „ E o
Recorded 01115%2013 at 02:17 PM, 1 z
o
Ronnie Fussell CLERK CIRCUIT COURT DUVAL y
COUNTY Notary Public atLarge siWj of
RECORDING$10.00 Mycommission expiressi=«seg
Peso�Ry45ncmn .> -
Prbduted ItlentRcation• F . or
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
n JJ r-
Job Address: r' Jam: him G� Permit Number:
Legal Description ' —Oct 3 $._a S--619 c &,'� arcel# 1 — c o 0
Valuation of Work$ �-� Propos or Area d Work heated/cooled L1 2 q non-heated/cooled t �05jZ
�(2e-moo )
Class of Work(circle one): New Addition teration `+ Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)((circle one): Commercial eside '
If an existing structure,is a fire sprinkler system installed? (Circle one): es No
Florida Product Approval# "��. LIL
For multiple products use product approval or
Describe in detail the type of work to be performed: R e i L kye f!"I ka 0 f d C( _
to 101 ►n - I&Wl N rl) r KO,0&4hmA; 6YTI�o'� SrfS a�
Property Owner Information:
Name: (fct tv� Address: 'I '� � Dv-,
City l�-1-6lc F> Ad— StateC�-Zip 3:2233 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:— aUtul�'S r 12rs Qualifying Agent:
Address:) (cam _City t5DAN I,i _ State Zip32zl !
Office Phone o Job Site/Contact Number qQ{-- Z51— 539a Fax# $(c4p - c";;1,
State Certification/Registration#_CCC 1?29 $AYS
Architect Name&Phone#
Engineer's Name&Phone# / �Q
Fee Simple Title Holder Name and Address l
Bonding Company Name and Address
Mortgage Lender Name and Address &pk4ee
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
:'s.euu,cz° that all•;c;;4 rvi!!he performed to meet the standards ofaQ laws regulating construction in this jurisdiction. This permit becomes null
and✓oid tf wo,k is not commenced withirt six(6)months, or if constructiort�r work is suspended or ul?urtdorted for tertod cg's x("5! s:.: r
work is commenced. I understand that separate permits must be secured or Electrical Work, Plu►nbing,Signs, ells, 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.
1 hereb certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether speci ied,herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other fedQ++µl, tate, or local law reguh, ng construction or the performance of construction.
Signature of Owner A.— Signature of Contractor
Print Name 1 QIAvd.)........ ........ lr ,� 1 Print Name Q�L .......L� P..l.,..... 11i...................:.
Sworn to and subsc 'bed before me Sworn to and subscribed before me
this"Day of 20 173 this �Day of t,rt_4 2013
SN
No ary Public Notary Public
Revised 01.26.10