652 Sherry Dr 2013 roof ,C,� ' , CITY OF ATLANTIC BEACH
1 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002081 Date 1/31/13
Property Address . . . . . . 652 SHERRY DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8858
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Application desc
reroof
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Owner Contractor
-
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COOK, MARK A BURGER ROOFING CO.
652 SHERRY DRIVE 134-1 ERNEST STREET
ATLANTIC BEACH FL 322335356 JACKSONVILLE FL 32204
(904) 355-2756
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 8858
Expiration Date . . 7/30/13
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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 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: 652 SHERRY DRIVE,ATLANTIC BEACH, FL 32233 Permit Number:
Legal Description 16-2S-29E SALTAIR SEC 3 LOT 81 Parcel# 170399-0000
Floor Area o —q t. Sq.1-1
Valuation of Work$8,858.00 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 Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval#FL10674.1
For multiple products usep—roTuct approvafl'orm
Describe in detail the type of work to be performed:REMOVE AND REPLACE SHINGLE ROOF.
Property Owner Information:
Name:
MARGARET REBECCA COOK Address:652 SHERRY DRIVE
City ATLANTIC BEACH State_Zip 32233 Phone 699-8405
E-Mail or Fax#(Optional)
Contractor Information.
Company Name: BURGER ROOFING CO Qualifying Agent: GARY BURGER
Address: 134 ERNEST ST City JACKSONVILLE State FL Zip 32204
Office Phone 904-355-2756 Job Site/Contact Number 904-237-9664 Fax# 904-358-0733
State Certification/Registration# CCC032514
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
that
work
on has
issuance ofa permt•and that allbwork in will bet performed owork
meeettnthe standards installations
ds of all laws regulating construction inothiisejuarisdictio . This permit be becomes n(tprior to ull
work is commenced.owork is mmenced of l understand that separate permits must be secution red for Elecuieawork is !Work,P inbingended or nS�ns or aWells,P riod ols,Furnaces,sBoimters t 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 BEFR ENTE RECORDING YOUR NOTICE OF
I
here work is
wthat I have read anill be complied with whetherp eeci redlhrein oon�ot o The granting of permit does the same to he true and not prAll esumettog ons vel authoaws trityrtotnviolategor cancve elt�he
provisions ofany other federal,state,or local Imv regulating construction or the prformance of construction.
Signature of Owner Q �1 6Signature of Contractor
[[ /^+�
Print Name r�T • W� Print Name �ry. �..._....... ......_......_....._...._..........................
.....�................................_._...........................................
Sworn to and subscribed before me
Sworn to,And subsce�ed before me 201�
this 43L Day of 20 fbay of oJC n
�c
No u is
Revised 01.26.10
LEE ANNE CABANAS
'JAP& R.MEREDITH
* MY COMMISSION#DD 977680 , * MV COMMISSION#DD 900284
EXPIRES:August 1,2014 EXPIRES:July 14,2013
sA °< bonded Thru budget Notary Services �1;`1e Fso�°p ceded Thru Budget Notary Services
T� pa
Doc#2013028546,OR BK 16237 Page 1026,
NOTICE OF COMMENCEMENT Number Pages: 1
Recorded 01!31/2013 at 10:16 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. RECORDING$10.00
Tax Folio No.170399-0000
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMENT.
l.Description of property(legal description): (1 70399-0000)16-2S-29E SALTAIR SEC 3 LOT 81
a)Street(job)Address: 652 SHERRY DRIVE,ATLANTIC BEACH,FL 32233
2.General description of improvements: REMOVE AND REPLACE SHINGLE ROOF.
3.Owner Information
a)Name and address: MARGARET REBECCA COOK, 652 SHERRY DRIVE,ATLANTIC BEACH, FL 32233
b)Name and address of fee simple titleholder(if other than owner)
c)Interest in property FEE SIMPLE
ii4.Contractor Information
a)Name and address: BURGER ROOFING CO, 134-1 ERNEST ST, JACKSONVILLE, FL 32204
b)TelephoneNo.: 904 .355.2756 FaxNo.(Opt.) 904.358.0733
5.Surety Information
a)Name and address:
b)Amount of Bond:
c)Telephone No.: Fax No.(Opt.)
6.Lender
a)Name and address:
Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address:
b)Telephone No.: Fax No.(Opt.)
8.In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(l)(b),Florida Statutes:
a)Name and address:
b)Telephone No.: Fax No.(Opt.)
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART I,SECTION 713.13,
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORIDA /J'A
COUNTY OF PINELLAS 1 O Ao9 `
Sign tur of er or Own is Authorized Officer/Director/Partner/Manager
"colt,2_T . 110oK
Print Name
The foregoing instrument was acknowledged before me this 81l3_day of 3 ,20.0 ,by
as (type of authority,e.g.officer,trustee,
attorney in fact)for (name of party on behalfofwhom instrument was executed).
Personally Known / OR Produced Identification Notary Signature
Type of Identification Produced Name(print) t,3&
OR
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
LEE ANNE CABANAS
* * MY COMMISSION#DD 977680
FORMS/N0C,rvsd2010 EXPIRES:August 1,2014
Signature of Natural Person Signing(inline#10.)Above
�7OF F?t Bonded Thru Budo Notary Services