555 Beach Avenue 2013 - Roof CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002351 Date 3/21/13
Property Address . . . . . . 555 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4500
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Application desc
reroof
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Owner Contractor
------------------------ ------------------------
WARNOCK HARRY C & ELIZABETH JAX ROOFING
555 BEACH AVE 601 ABBEY CT DR
ATLANTIC BEACH FL 322335323 ORANGE PARK FL 32073
(904) 434-7346
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4500
Expiration Date . . 9/17/13
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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
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH /
/ ROOFING PERMIT APPLICATION �J j
Date:
Job Address: �� ����` c^� ✓C
Owner of Property:
Address: C,' C 41-- 14 6/Q Telephone: t T -7 3 V-4�,
Roof Contractor: CJ r State License Number: , �C 2 0 Zl
Contractors Address: got G
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t,� 11 . I f F-
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Telephone�D ( F-5 �7a�� Fax: —70 / �72- �7��ail: ( / �f ``--7C- �.J� �/"�/� o
Scope of Work: f �U Roofing Material G �d ,
FL Product Approval# L Valuation of Work: $ / J g
Required Inspections: Sheathing/In Progress-Dry In /Final
If re-roof: Assessed Value of Structure: 300,000/_>$300,000;Roof-to-wall improvements required?
(Applies to single family structures only)
"WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
LENDER OR AN ATTORNEY BE ORE RECORDING YOUR NOTICE OF COMMENCEME T S I r...
3b ;
SIGNATURE OF OWNER: Date: 0 ,
AS TO OWNER: f T X o D
Sworn to and subscribed before me this �day of /�G' ' G 20J1. i K $
State of Florida,County of Duval �.-e o i N
C
Notary's Signature: ( I n
onally known H u
❑ Produced identification m O
Type of identification produc '�' W Z
SIGNATURE OF CONTRAC Date: 1 ' 13 _.j
AS TO CONTRACTOR:
Sworn to and subscribed before me this 1 day oProduced
State of Florida,County of Duval
Notary's Signat
AM
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f 0000957760
n rt}kltUtry14,2014
-:ty PuWic Underwriters
Type of identpro ucetl.:' _j�2;
800 Seminole Road•Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800-Fax:(904)247-5845
F:\roof permit applicaton.docx 7/28/09
Mar 25 2012 4: 39PM HP LASERJET 3200 P• 2
NOTICE OF COMMENCEMENT
r /'J (PREPARE IN DUPLICATE)
Permit No. ! 3 - V �3�� Tax Folio No.
State of County of
To whom R may concem:
The undersigned hereby Informs you that improvenwate will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Mformadoe is stated In this NOTICE OF
COMMENCEMENT. �y
Legal description of property being improved: SSS eGtGGj Com` v�"
Address of property being improved: C_ve w
General description of improvements: Re-roof
oe 4—
Owner G�r/ C
Address
Owner's interest In site of the improvement N/A
Fee Simple Titleholder(if other than owner) N/A
Name N/A
Address N/A
Contractor Jaime Tulio Cardona Jax Roofing LLC,
Adder 496 Hillside Dr.Orange Park, Flcrida 32073
Phone No. 904-434-7346 Fax No• 904-772-9947
Surety(f any) N/A
Address N/A AmountoTbond$
Phone No. N/A Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address N/A
�. Phone No. N/A Fax No.
Name of person within the State of Florida,other than himself,designated by sumer upon whom notices or other
documents may be served:
Name N/A
Address N/A
Phone No. N/A Fax No.
In addition to himself,owner designates the foliowing person to receive a copy of the Lienor's Notice as provided In
Section 713.D6(2)(b),Florida Statutes.(Fill in at Owner's option).
1 v Name N/A
Address N/A
Phone No. N/A Fax No.
Expiration date of Notice of ComnvNwemerd(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
Sic AM
Belbre NITS day of C m tree ;
-- Coun over,State M F aso a retl
dr In by r7
Dock 207307 *rS* herself an aff mrs that all statementa and dederations herein
Number Pages:: ! m
1 OR Bk 163Gf!2 Page,21m are true and acc
Recorded 03125,2013 at 04:1D Pf,Q,
Ronnie Fussell CLERK CIRCUIT COURT DilVAt. t S
COUNTY
RECORDING$10.00 N P at Large,Stele ourlty d m O
issfon expires:
mnarly Known 2 or
Produced Identifiae0on_ 45
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