337 1ST ST ROOF 2013 \S ley
CITY OF ATLANTIC BEACH
1 j 800 SEMINOLE ROAD
J = ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002418 Date 4/03/13
Property Address . . . . . . 337 1ST ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5200
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Application desc
REROOF
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Owner Contractor
MCCARTHY TRUST GREAT WHITE CONSTRUCTION INC
MCCARTHY JOSEPH, JOHN, ANNIE 4320 DEERWOOD LAKE PWY
337 FIRST ST JACKSONVILLE FL 32216
ATLANTIC BEACH FL 32233 (904) 838-1659
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 5200
Expiration Date . . 9/30/13
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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 80 . 00 80 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 84 . 00 84 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of 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,
Legal description of property being improved: S'C,q (,•ZS-a-S
i9k�Gn{�C.l3ch
Address of property being improved: 3-3-1
l 5�
A�kAA,
General description of improvements: �� u
Owner
Address- 3 37 1 S�Sk A��r i1{ate �� Ft— 31135
Owner's interest in site of the improvement
Fee Simple Titleholder Of other than owner)
Name
„ p Address
J� nu Contractor G I".eat Woi Fe ('oi1Sj'tuctibrl
Address�3.;;Lb De-e-- =YJ C-A-le PbrgjLcLz,� J"
Phone No. Gl - )S `S ((�S G/ _Fax No. &
Surety Of any)
Address Amount of bond 5
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 j
Phone No. Fax No_
In addition to himself,owner designates the following person to receive a copy of the Lienors 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 01� ER
Sia"I.
U DATE-3'Z0-r3
aefday o in the
Coof Florida,has personalty appeared
t�USer�h M°CC e¢tw herein by
Doc#2013082137,OR BK 16313 Page 607, himselff herself1rid affirms that all sta-ments and declarations herein
are true and accurate nvPteNumber Pages: 1 TRAVIS SLAUGHTR
Recorded 04.103%2013 at 08:24 AM, * My COMMISMUN;EE 162134
Ronnie Fussell CLERK CIRCUIT COURT DUV"AL EXPIRES:January 22,2016
COUNTY ,� �TSIFOF�pR�P BotldedThmBudgetNotarysemms ILII
RECORDING$10.00 No a- Publ cv at Large,State of , County of
My commission expires:
Personally Known or
Produced Identification
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: S37 V rsk Permit Number:
Legal Description S'-(o9Parcel#
Floor Area o �q t. q.Ft
Valuation of Work$ .rioo 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): Commercials'de
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval# L4-lq•13
For multiple products use product approval form
Describe in detail the type of work to be performed:
C'cr a--�c F twD c—"k
Property Owner Information:
Name: 5x-tee-Ch M`Ccs-Ahm Address: 33-1 Firsk Sk
City 41k13ch State W Zip _ Phone 9os•6t3-(Ss-1
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: G,<-cc k u ti Ar- Qualifying Agent: -1kc-u:c SNc hvv
Address: tika , oa>~r.VV-V'& ULk-e City Zt.., State Fi. Zip?zz1L
Office Phone `too U k 1(.55 Job Site/Contact Number Fax#
State Certification/Registration#
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 hemade 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 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 six6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,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 o1 certify
will be complied 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 other federal,state, or local law regulating construction or the performance of construction.
C `
Signature of Owner LD7L4
Signature of Contractor M �` -
Print Name h M�C c,r Print Name \�vt.S.....M........ .�h. .!. .........................................
aCA............. ................................... ........
Before me Befor e
this-_Day of Qor,l 20 13 th' ay o 120
�— R � 0 1e� 4 Y L.GRANotary Public • ° -.: klll SION><o 957
* k MY COMMISSION A EE 162194 ! ' EXP11ES:February 14, 014 Revised 10.24.12
EXPIRES:January 22,2016
BUnded Tbrll Budget NOtery Services
sr : rorided"I hn!Notary Public underwriters
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