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Permit Roof 1912 Hickory Ln 2013 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002030 Date 1/22/13 Property Address . . . . . . 1912 HICKORY LN Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 9000 ---------------------------------------------------------------------------- Application desc REROOF ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ WALLACE FORREST L NELIGAN CONSTRUCTION (ROOFING) 1912 HICKORY LANE PO BOX 49249 ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32240 (904) 247-3777 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 95 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 9000 Expiration Date . . 7/21/13 ---------------------------------------------------------------------------- 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: 1°I i Z IA-k kcyr./ Lan& A"�_ j5da-33 Permit Number: Legal Description No -7& 0q .-aS-aq P--)eJyS M i t vv M& G b Parcel# l•^1 a 0 Skb` i 3\ ;z Floor Area of Sq'q.. Ft. Sq.Ft Valuation of Work$ (11000 -00 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/proposed structure(s) circle one): Commercial R tial If an existing structure,is a fire sprinkler system installed? (Circle one): ,es No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: 'P,®c V (-0\C1,C�_, MtVA Property Owner Information: Name:Voge-A L WcMcxC.l_ Address: 1q `Z• 4�CKC�,Cle City k�kaf\ •C. �PoQ State Zip 3�)ka33 Phone a,Lk!A- 1+-E 7 E-Mail or Fax# (Optional) Contractor Information: Company Name: N UY1� Qu lifying Agent: Address: .©• < city h, i t lle-- e0 State \—l0 C dc,Zip 5 3,aq0 Office Phone 95'53- C1 115 Job Site/Contact Number Dc;x506-<2�-170 Fax# State Certification/Registration# 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 wall be performed tom ,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. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters, Tanks and Air Conditioners,eta 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 hereby certify that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci aed herein or not. The granting of a permit does not presume to gave thoriry to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. Signature of Own/e Signature of Contractor ` Print Name .GT /2.. ..........1/ICG.��Gj...�....L�..................................................... Print Name 1�).0:w-`R.....��. 1 . Y .................................................. Sworn toand subscribed before me Sworn to and subscribed before me this-�JL Da of _k V` 20 this A5�Day of 20 IL Notary P isp ` °5 MY COMMI StON D973752 (� �ti irANGiLLE EXPIRES March 22,2014 -�. *: , i ':)iv L331oN#D0973752. ES t,AarCh 22,20 4ev ed 01.26.10 NOTICE OF COMMENCEMENT State of r" C C-'k,&- Tax Folio No. 1 -7-DQ-a0 ._ j 3`Z Countyof -UkkVaA 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: Address of property being improved: (2t, QSi —'aS'---l'"(U t� ��� , tib t- "a LLA General description of improvements: Owner: oyr?-&� I— y%^ k lw:_ . Address: c11 Owner's interest in site of the improvement: 3z L3� Fee Simple Titleholder(if other than owner): Name: `` Contractor: eAxl l� T Ct' . 1� `� , l-1. Address: 1' L'. `t`1 JC k . -Sy,lk_1i U Telephone No.. c �(?�/) �...)J? -(a�( rFax No: 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: 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: 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 OWNER Signed Date: 4efore me this day of in the County 6f Duval,State Doc#2013017739,OR BK 16223 Page 1484, >f Florida,has rsonally appeared Number Pages:1 lotary Public at Large,State of Florida,County of Duval. Recorded 01!22/2013 at 09:43 AM, 1y commission expires:__,(v.�: � •�Z Z�j �� Ronnie Fussell CLERK CIRCUIT COURT DUVAL ersonally Knownr"•--—— COUNTY roduced Identifichtiip{ic` or RECORDING$10.00 :..� IUY COMMISSION 00973752 _ t� 5 "Li,T >rxPRLr-t AWarbh 2-2,;7014 �'��-Na-0.J.Q-3, ,