158 Poinsettia 2013 roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
1 SA
19
Application Number . . . . . 13-00002261 Date 3/05/13
Property Address . . . . . . 158 POINSETTIA ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3400
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Application desc
reroof
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Owner Contractor
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STELZMANN, ANDREW DAVID MERRITT CONST. CO. (ROOF)
184 POINSETTIA STREET 108 FLORIDA BLVD
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 993-1697
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3400
Expiration Date . . 9/01/13
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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 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 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
JobAddress: powse;t� Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel# Sq.Ft
Valuation of Work 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 1��iden�'
If an existing structure,is a flre sprinkler system installed? (Circle one): es No N/A
Florida Product Approval # F I. L/qy , /
For multiple products use product approval form
Describe in detail the type of work to be performed: Rtx_a�—p
Property Owner Information:
Name: kd-k -_7_rn6Ln r) Address: 1.5-5 Poi t,,5e+h:7_
A 5494, -
City A-:4- ) 3�A�, Statet_:�LZip_37Z33Phone (P;R?—a(oak
E-Mail or Fax#(Optional
Contractor Information:
Company Name: V id MW I H bdS� C6 MKQ.alify-ng A ent: eL&SQ eir I
Address: 170 irvto 94 Ci VIVIlle State c,-- zip-.32Z02
Office Phone 2 2-0-3 7/ / Job Site/Contact Number��Fax
State Certification/Registration# C(_C132�G-`1119
Architect Name&Phone# 4
Engineer's Name &Phone 4 1
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address E�
ca here ade ob ain a ermil 10 do the work and installai�ns as'pdic or installation has commenced prior to the
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f
p be e 0 ed a_Z"he 'an ar a �w thisjurisdiction. This permit becomes null
d ha a, k i m
0 k s aWeriod of sixJ6.)months at onv time after
n r s 0�
n n i.(6 _ nth, or c _st ct an r
i 'i�ais '.'y p
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d "d, _ok is ot co-me iced w thin s 0 0 r' r
n 1. r, n t t p rate p r_i;s t cur f
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c f me , d d, ta d a se a e be e ed E e d1s, Pools, urnaces, floileis, Heaters,
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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 oflaws and ordinances governing this
type p�work ivill be coTplied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal,state, or local i aw regulating construction or the peFfo�mance of construction.
Signature of Owner 4VO141- Signature of Contractor(1&"4c_ V&4�_L
Print Name A6(XW Print Name
........................................................................................................................................ ...................................................................
Swo se d be' re me Sworn subscribe before .
aan r I-
this �) Day o:: . 20/_3 thi D of
2013
............ S IRL
KKII I ivi
Notary Nblic I
DAVIr, E ME EXPi E ebruary 14,2014
cotot,,�ISSION#DD926677 Bonded ry Publ gig
1.26.10
1,,mber20,2013
L_(40Tff?
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
NOTICE OF COMMENCENENT
State of Porro(L Tax Folio No.
County of tlAtva-ll
To Whom It May Concem:
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 t.4is NOTICE OF�ONCV�ENCE
Legal Description of property being improved: fA- _5
3 -,7 Z
Address of property being improved: ib I r)S
General description of improvements: 0
Owner: 4nfJA4 Z-ry]" Address: Po m,etit-t ABX -3zzz3
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: DA" \Of V, 1-H cDtlT+ cb-fric-
01�1�A Address: Qq GlrV10 W-d
V %Telephon"e No.: 9 cl Fax No:
Surety(if any) Amount of Bond$
Address:
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: Fawx 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: 2 0/-
Doc#2013056042,OR BK 16276 Page 136-1. Before me tV 15- d of in e Coun uval,S
Of Florida,has personally appeared
Number Pages:1 Notary Public at Large,State of Florida,County of v -
Recorded 03/05/2013 at 10:22 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL My commission expires-
COUNTY Personally Known: or
Produced Identification: F tAERRITT
RECORDING$10-00 —1c
it-!4 DD926677
-rnher 20,2013