365 1st St. (vault) 000420
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
LOCATION INFORMATION
Per-mi I t Number: 420 Add veaiii: 3G5 FIRST STREET
ATLANTIC BEACH, FLORIDA
Permit Typet TREE REMOVAL LEGAL, vESCRIPTION
Cl (� Works N/A Block i Sec t i on i
cor Typet H/A Plat Book: Page: 0
Pro u sed Use; SINGLE.: FAMILY ion: 'A"
Dwel i ngs3 0 code; 0 subdivi.8
Ceti ated Value: $ INFORMATION
0. OWNER
14 Ear ov. Cost: *0.0() Namet FRANK AND DOROTHY KERB ER
Total r $0.00 Address; 365 FIRST `:STREET
$0. 00 ATLANTIC REACH, FLORIDA
PhtA
iN
APPLICATION FEES
PEIRKIT
WATER IMPACT FEE
SEWER IMPACT FEE
WATER M`M�R
RADON GAS R. 9.1
RADON GAS 5% $0.00
WATER TAP $0.00
SEWER TAP
HYDRAULIC f,-3 14 A R R .$0.00
RE--INSPECT FEE $0.00
ENGINEERING $0.00
OTHER $0. OAD
NOTES:
NOTICE — ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER.
"FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS."
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
ATLANTIC BEACH BUILDING DEPARTMENT
By:
NOTICE OF COMMENCEMENT
Ln 5 MIN. RETURN
~ TO WHOM IT MAY CONCERN: PHONE #
cm
The undersigned hereby informs all concerned that improvements will be made to certain
real property, and in accordance with Section 713.13 of the Florida Statutes, the following
information is stated in this NOTICE OF COMMENCEMENT.
14 Description of Property
o�
0
10644
o
Pa el. 754
pq General Description of Improvements — ��� Fl & Recorded
05/17/00 11:40:23 AM
1 ) CLERK rTRrnTT COU
Owner 0 V`Z� J(e. it ) D TRUS COUNTY
TRUST FUND f 1.00
Address: �,
t 5.00
Owner's interest in site of improvements: nwi;"eA,
Fee Simple Title Holder (if other than owner)
Name
Address
Contractor 9 y.e 4 4, d /C�f g x1
Address
l � Surety (if any) ez
Address Amount of Bond $ A
Name of person within the State of Florida designated by owner upon whom notices or other
documents may be served:
Name
Address
In addition to himself, owner designates the following person to receive a copy of the Leinor's
Notice as provided in Section 713.13(1)(F), Florida Statutes. (Fill in at Owner's option).
Name �✓ /�
Addres
Owner
Sworn to and subscribed before me this qt� day of
Notary Pub INA P KILIS
N LL,1ftnlic. State of Florida
My =Rm. u p. Aup. 34: 2M3
Comm. No. CC849677
f �t N
RE"
CITY OF ATLANTIC BEACH
O ROOFING PERMIT APPLICATION City o Atli ,,
auilding and Nch
JOB LOCATION: ✓ '� �' "� S J �'
7
OWNER OF PROPERTY: ��r� //V .1 e/� K�e1�( ELEPHONE::
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