Permit Roof 1655 Beach Ave 2013 '1 f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
,��►,� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002134 Date 2/11/13
Property Address . . . . . . 1655 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
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Application desc
reroof
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Owner Contractor
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HAAS, ERIC OLD WORLD CRAFTSMEN INC
1655 BEACH AVE P.O. BOX 1815
ATLANTIC BEACH FL 32233 LAKE CITY FL 32056
(386) 758-3264
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 8/10/13
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Special Notes and Comments
need noc
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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
Grand Total 80 . 00 80 . 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
�Z,>3
Job Address: &55 �d P14-ts vi-�-ic. Pj&ch , FL Permit Number:
Legal Description o3bq8 /V Or4fi fic
Parcel# 16,9655--DDoO
Fl
oor ea o q. t. q*Ft
Valuation of Work$ Proposed Work heated/cooled A/)q non-heated/cooled_11VA
rvof —,`_Jevoal,l 7 -i v �+ `� V1(w =til s I-j�i..S is _
Class of Work(circle one): New Addition Alteration ai Move Demolition p�I iii
Use of existing/proposed structure(s)(circle one): Commercial Residentia
I�
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/ F; 1 1 2013
Florida Product Approval # /37/'/—)Z1 Un1. F1_ 3 q43 -
For multiple products use product approval-Form
Describe in detail the type of work to be performed: ue- of kr-4" dr
_rT0 rm - wm6irrncv S S 5 tl ,&� al4m 1 h -53 C e-aae—
I
roprty Owner Information:
Name: `C 16f, Address: 1 7 3 a ea6k
City AilLiy4ic eAch Stated-Zip �Phone
E-Mail or Fax# (Optional) i ne a rN
Contractor Information:
Company Name: DtA QortJi, Cm-( h% . 4,c—Qualifying Agent: ivz o
Address: a a Lt,
O City � C State F t, Zi 27 5a
Office Phone 31U,-=7 'S-Uo Ll Job Site/Contact Number Fax# .38b— ?Sct- Y $7
State Certification/Registration# C GC 15)S
Architect Name&Phone# kVA
Engineer's Name&Phone# h/9
Fee Simple Title Holder Name and Address /-j
Bonding Company Name and Address hi A
Mortgage Lender Name and Address N ft
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work wall 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 siz(6)months, or if construction or work is suspended or abandoned for a_peraod 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, I urnaces, Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWI 12 XAJLM
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINA CONSUCIPDWITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDI ' "I�e rile
COMMENCEMENT. y amm. xv s a tots
" ', Commission#F EE 177204
Bonded Thro h National Notary Assn.
I hereby certify that 1 have read and examined this application and know the same to be true and correct. All is
type o1 work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
C
Signature of Owner r Signature of Contractor (4,
Print Name �r Print Name
....... .................................j..................................................................
Swo d sub ribed e2 Sworn o and subscried before me
thi Day of 2015- this T Day of 1 G/�74klj 120 /3
HAM
No u =* DD 957760 N Public
o: EXPIRES:February 14,2014
nded Thru
Notary Public Underwriters Revised 01.26.10
n,,. Bo
RECORDING $10.00
NOTICE OF COMMENCEMENT
I�1 C
State of DY1 �'`- _ Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is to ed in this NOTICE OF COMMENCEMENT. �- 32z 33
Legal Description of property being improved: Sa (�[7Z:x� re'�5 urs► i� ai ,c_se.-, ,
Address of property being improved: !az-Z-3 3
General description of improvements: rts�ut
`+tuj 1Mtg:7: C4 turn bium Couniti, 5i w-7l/—"I/-
Owner: Yi C t R` f� Address:
i' /�S �G/ i3?,_ G►ti 'iZ6�t FL-
Owner's interest in site of the improvement: o ham.S;;Y �
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 1_ (v'7�t'1Address:—?. D., ?_->t>Y- -w-)2 LaKe_ 1!'cvy , f--4- 37P5(
Telephone No.: (3-96) � Fax No:
Surety(if any) /NA
Address: Amount of Bond$
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:AYLL._
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: i4
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): - r,---- -
THIS SPACE FOR RECORDER'S USE ONLY OWNER °
Signed: S _ Date: a-4,—)3
Before me this^ I I day of in the County of Duval,State
Of Florida,has personally appeared
Notary Public at Large,StatF r' ,Co7-0-2 uval.
mmission expires: _
SHIRLEY L GRAHAM Persled
ally Known: r
0
MY CQMMISSION M DO 95776 od Identification.
; = EXPIRES:February 14,20ff 4r —
1 ��' Sanded Thru Notary Public Underwr fere