355 Skate Rd roof 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jjilt
Application Number . . . . . 13-00002427 Date 4/04/13
Property Address . . . . . . 355 SKATE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4850
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Application desc
reroof
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Owner Contractor
-
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THOMAS, MARIE PRIME ROOF CONTRACTING LLC
355 SKATE ROAD 13792 HERONS LANDING WAY #9
ATLANTIC BEACH FL 322333819 JACKSONVILLE FL 32224
(904) 625-1446
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4850
Expiration Date . . 10/01/13
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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 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.
NOTICE OF COMMENCEMENT
State of �����7�� Tax Folio No.
County of yxy-
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:
Address of property being improved:
General description of improvements: t'(Y)r'
Owner: &-- -1--Y'19,4445 Address: '� 6KAZ5 �C2.Q lam'
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
C ntractor:
Address: Ng4
Telephone No.: Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:_ Doc#2013084135,OR BK 16316 Page 1188,
Name and address of any person making a loan for the construction of the in Number Pages:1
Recorded 04/04/2013 at 11:49 AM,
Name: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING$10.00
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: te:
4(-3 -/3
Before me this day of in the County of Duval,State
0®ORAFIAMIW)A IN14M Of Florida,has personally appeared alt 19�C.0 er"
fti
.: MY COMMISSION#EE 06730 Notary Public at Large,State of Florida,County of Duval.
w` EXPIRES:May 21,2015 My commission expires:
,Y 0^ Thru Notary Publk Underwriters or
�—
Personally Known:
Produced Identification: „
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: A Permit Number:
Legal Description �{�/ t_��j(/t,[� !�4 Parcel#
oor Area o .1 t —Sq T
Valuation of Work$ Yo JV. Proposed Work heated/cooled qA1� non-heated/cooled_Z
Class of Work(circle one): New Addition Alteration Repair molition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): Commercial Resi
.' No
If an existing structure,is a fire sprinkler system installed?(Circle one: es No N/A
Florida Product Approval#FL 166y :!27
For multiple products use product approval torm
Describe in detail the type of work to be performed:
Property Owner Information:
Name' Address:��S�
CityLat/17L_ /i StateFl_ZipjZZ Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company NameAlbAtoi Ani-1- (�. Qualify'ng Agent:
Address:[���A6 (A Ak � City .t ILL� a State A4- Zip Ju
Office Phonegoy COZ5 ( Fj Job Site/Contact Number y Fax#
State Certification/Registration# t a /3Zq- 5b5
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 be performed to meet the standards of a(!laws regulating construction in this jurisdiction. This permit becomes null
and void jwork is not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of sir 6)months at anytime after
work is commenced. /understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,1(urnaces,Boilers,Healers,
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.
/hereby certify that/have read and examined thisfa lication and know the same to be true and correct. A/1 provisions of laws and ordinances governing Iters
type o work ivil!be complied wish whether sppeed ted herein or not. The granting oja permit does not presume to gW7ahonryfolate or cancel the
Provisions of any other federal,state, local lawrulating c t ction or the performance of construction.
Signature of Owner• ature of Contra for
Print Name /�/� _� Print Name
Sword su c ed efo?e e /3 „ Swo an su re rile
ccc//!ay o 20 /. ` / thi ay of 20
17
Notary Public /�. c
evised 01.26.10
r°ty DEBORAH AMANDA WHITE SHIR _
2
My COMMISSION N EE 067349 L Z
*. r9Y COh7
Sltl
a►: _ :v OU60
EXPIRES:May 21,2015 XPIRES:Febrilary 14,2014
*, Bmnded Thru Notary Pubk undmKdem Rf 60rded Thr"Notary Public,Undervffiters