Permit Roof 2263 Barefoot Trac 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002156 Date 2/14/13
Property Address . . . . . . 2263 BAREFOOT TRAC
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6500
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Application desc
re-roof FL#10124 . 16
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Owner Contractor
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MARTIN RAYMOND D JR GREAT WHITE CONSTRUCTION INC
2263 BAREFOOT TRACE 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 322334565 JACKSONVILLE FL 32216
(904) 838-1659
--- Structure Information 000 000 REROOF
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Permit . . . . . . ROOF PERMIT
Additional desc . . RE-ROOF FL#10124 . 16
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6500
Expiration Date . . 8/13/13
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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 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 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: 9? G J Rd r te,&t /T-d c,-, Permit Number: 3 j 1 sh
Legal Description 63' C)e"o, d ati i i F 0 - Parcel#
Floor Area o CI.M. Sq*Ft
Valuation of Work$ G o 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 # 1 t�,l z-q 1 le
For multiple products use product approval orm
Describe in detail the type of work to be performed: 7-'0 - 7-00 0C 4 It 35-�
Property Owner Information. J
Name: /A Address: G
Cityen
State F Zip Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ry c-y Ccs ,Y-k2Qualifying Agent:
Address: 42)2-c L,& City s,-e State E- Zip ?,ZZ t{-
Office Phone riM S 3k-155 Job Site/Contact Number IoK%3 I L 5 S _Fax# 11g(,-18q0
State Certification/Registration# 132 9�5
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. I 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 aperiod of sax 16)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 o7work will be complied with whetherspeci led herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other feder 1,state, or local law regulating construction or the performance of construction.
r.
Signature of Owner Signature of Contractor
Print Name ................................O..r....r.......
Print Name
............................................................
........................<..... � .....
............................................................... .........
Before ` Before me
this ay f 20 this 1y Day of 120
N 1 c ti r.''. SHIRLEY LGRAHAM ,�it1'trr o awww
*; MY COMMISSION#DD 957760 =.: *= MY COMMISSION#EE 861935 Revised 10.24.12
o` EXPIRES:February 14,2014EXPIRES:January 1,2017
Bonded Thru Notary Public Underwrit
Bonders y Bonded Thru Notary Public Underwriters
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Doc # 2013040853, OR BK 16255 Page 955, Number Pages: 1 , Recorded 02/14/2013
at 10:55 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT. / Y
Legal description of property being improved: o� �Z("
Address of property being improved: a
rr12 3
General description of improvements: Re roof
Owner04fV4- tT arc.. ,Q Il7ati /�c
Address 7a 6 .3 lei. f
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner) ." l
Address
Contractor_ �� Cyr�k c,v��r •� ��
Address_11331 1r v �n r l caLc rL 3�i (�
Phone No. Q O4 638 14 S Fax No. t—8(.L,L,..-7 q4 f 8Y0
Surety(if any)
Address Amount of bond$
Phone No. Fax No.
Name and address of ny 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 //f�ed:
Name /'t
Address
Phone No. Fax No.
In addition to himself,o er designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06 O ), rida Statutes (Fill in at Owners 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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY NE 7
Sipned� r DATE G 13- 13
Before rm this day o in the
Cornly of Duval.State of Florida,has person appeared
herein by
himself/herself and affirms that all statements and declarations herein
are true and accurate_ 1
I
or
POW
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