480 w 14TH St ROOF PERMIT CITY OF ATLANTIC BEACH
+ 800 SEMINOLE ROAD
s� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002452 Date 4/10/13
Property Address . . . . . . 480 W 14TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5300
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Application desc
REROOF WITH NEW MODIFIED BITUMEN
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Owner Contractor
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_ _ __ ----------
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COX, HERBERT J OWNER
480 W 14TH ST
ATLANTIC BEACH FL 32233
- --------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . MODIFIED BITUMEN ROOF 00
Permit Fee . . . . 80 . 00 Plan Check Fee 5300
Issue Date . . . . Valuation . . . .
Expiration Date . . 10/07/13
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- ----------------------------------
Special Notes and Comments
NEED RECORDED NOC PRIOR TO FIRST
INSPECTION.
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Other Fees
STATE DCA SURCHARGE 2 . 0
• STATE DBPR SURCHARGE 2 . 00
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 4M V/ 14J-'-' Permit Number:
Legal Description )--I-o&Aq£ 6FC, H M71f,hbVarcel# i_' ()�??_()DM
oor Area o q. t. Sq.Ft
Valuation of Work$'6'6W 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
If an existing strucure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: Ke-rCb r)
Fw-n J f ne4�L n�t,y 1- od 1-6�d c_b)�h _rne n 12-1- 6146 m
Property Owner Information: r,
Name: � Address: '-t W� u `
City oln C11Stateip Phone L4-oR 02101
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Ch 1Owb- �V(I� ► Qualif in Agent: 0111 j0uyb
Address: City State Zip Aa
Office Phone —C.( Job Site/Contact Number L - Fax# Cj )Ll-
State Certification/Registration# GGi04L4,;Lb
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 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 a period of sixP6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, urnaees,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.
1 hereb certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of l and ordinanc�e: !:ninghis
type olYwork will be complied with whether speci aed herein or not. The granting of a permit does not presume to gr authority to violthe
provisions of any other federal,state, or local law regulating construction or the performance of construction.
.Signature of Owner Signature of Contractor
Print Name /-/e' .. �.. ........v..:........ ...G'.x.................. Print Name ..... ...... :h V �C ...........
Sworn to and subscrib d befo e me Swor to and subscrib d befove me
this ay 20 this Day of201
N E• N t ublt�EL
My COMMISSION#EE157752 MY COMMISSION#24,EE157752
2a,2016 EXPIRES febru� "Zola Revised 01.26.10
E?PIRES:Febr°aTY pl N.,. a oo t Assoc.Co.
Fl.Notay piscottnt Assoc.Co.
1-800-3-NOTARY
1-80!1.3-NOTARY
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NOTICE OF COMMENCEMENT
�j (PREPARE IN DUPLICATE)
Permit No. ✓ Q2 9
21 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 Ficrida Statutes,the following information Is stated in this NOTICE OF
COMMENCEMENT. G
Legal description of property being improved: �✓ 1 G
R T 1
Addres of property being improved:
-- _�, Pr a22,�
Gener I desc[iption of improvements: f +! 'v( U 0 11 Od I l�d
/I'Zti+
Owner - 3
r Q{� Y06h f�-- � ,3
Address 2 t l ��1 I+�r-YI t j
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor j
Address l
Phone No. �nur�r�jJ 7� J Fax No. �Vu �ir1Cl� S j
Surety(if any)
Address Amount of bond$
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
Phone 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 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 / OWN R it Z W N
i js
LDATE :. U J� Q 2eforemday of
County of Duval,State of Florida.has personally appearedc C
herein by W
himself/herse!f and affirms that all statements and declarations herein W
are true and curate W}
r: x r >
bo ct
Notary Public at Dirge.State of-.. County of
My commission expires:
Personally Known or
Produced Identification