Permit Reroof 387 3rd St 2013 CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
0 :" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4 fit
Application Number . . . . . 13-00002236 Date 2/28/13
Property Address . . . . . . 387 3RD ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4788
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Application desc
reroof FL #11956 . 3
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Owner Contractor
------------------------ ------------------------
CARTON ROBERT G LEAKBUSTERS LLC ROOF
387 3RD ST 6040 GEORGEWOOD LN W
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32244
(904) 778-4377
--- Structure Information 000 000 REFOOF
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF FL#1956 . 3
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4788
Expiration Date . . 8/27/13
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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 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
1d^ L-21t�- 3 3y,. 55 S91 &+L-�
,25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 n
Office(904)247-5826 Fax(904)247-5845
Job Address: 3873 d st atlantic beach fl
#Legal Description 5-69 16-2s-29e 093 atlantic beach Parcel
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 4788 Proposed Work heated/cooled non-beated/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 X
If an existing structure,is a fire spri ler system installed?(Circle one): Yes No N/A
Florida Product Approval# fl1956.3
For multiple products use product approval form
Describe in detail the type of work to be performed: reroof
Property Owner Information:
Name: rob carton Address: 387 3`d st_
City atlantic beach State fl_Zip Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Leakbusters llc Qualifying Agent:
Address:6040 george wood In.w. City Jacksonville State fl Zip 32244
Office Phone 904-778-4377 Job Site/Contact Number 904-334-5559 fax#904-772-6682
State Certification/Registration# ccc1328512
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 will m performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void rf work is not commenced within six(6)months,or if construction or work is suspended or abandoned for apenod of srx/6)months at any time alter
work is commenced. 1 understand that separate permits must be secured for Elecdical Work Plumbing,Signs,Wells,Pools,Funmces,Boilers,Heeler;
Tanks and Air ContUtloners,ete
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 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 o1 work will be complied with whether specs red 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.
Signature of Owner Signature of Contractor
Print Name ........_.VOSCA: CMA" l Print Name h/ � S 1 t/ .G?..N 1.........
................... .................................................................................. ......................................... .............................. .
Sworn and subs r' efor a Swomzn���
this Day of . R 2 thiszoNotary Public ota
Revised 01.26.10
EEb
MELISSA A FUUiTCOMMISSION#EE 861935XPIRES:January 1,2017d Thru Notary Public Underwriters
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of tiorida County of duvai
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: 5-6 9 l 6-2S-29E 093
Address of property being improved: -387 3rd St A l n t i c Reach Fi
F a
General description of improvements: roof
Owner Rob Carton
Address 387 3rd st Atlantic Beach FL
Owner's interest in site of the improvement h camp
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor T. A khi ig t-in T,l r
Address
Phone No. 904-778-4 77 Fax No. 904-772-6682
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
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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: [c!1 DATE L Frt313
Before me this — day of `t- = n the
County of Duval,State of Florida,has persona y appeared
Doc#2013050812,OR BK 16269 Page 578, herein by
himself/herself and affirms that all statements and declarations herein
Number Pages:1 are true and accurate
Recorded 02127/2013 at 10:45 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
Notary Public at Large,State of County of ,
My commission expires: f�llA 2 C t 4
Personally Known or
iProduced Identifications to 1
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