87 Donner Rd reroof 2013 CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J r)
►� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002525 Date 4/23/13
Property Address . . . . . . 87 DONNER RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4935
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Application desc
REROOF
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Owner Contractor
-
------------------------
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SANFORD, SHEILA P. DAVID MERRITT CONST. CO. (ROOF)
87 DONNER ROAD 108 FLORIDA BLVD
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 993-1697
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4935
Expiration Date . . 10/20/13
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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
PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of T 141 County of a V<
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: 9 7 hoer ed
� ZZ33
Address of property being improved: 0r7 ner /-01
Ville F/ 3zz33
General description of improvements:
Owner S k, S-Q/n-pord
1 f� 1
Address V f-b r1 YI
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor ( (�
' r Address 17 C 4 C—,' ,r V1 n aa suit Z Z ZS
1 � Phone No._ q 3 JIG'4 Fax No. ZZd 3�7 7
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 OWNS
A6Sign DATE w/3
Before me this ay of ;n the
County of Duval.State of Florida. ally appeared
herein by
himself/hersalf and affirms that all statements and declarations herein
are true and acwrate
Doc#201310053,OR BK 16339 Page 123,
Number Pages: 1
Recorded 04/23/2013 at 02:37 PM, C
Ronnie Fussell CLERK CIRCUIT COURT D
UVAL I
COUNTY NotalPhlic at Large.State of , County of „vv�
RECORDING$10.00 My commission expires:
Personally KnownRRfTT
Produced Identification DA
=• ; w MY COMMISSION#DD926677
!`ter PRC ;!'eptember 20,2013
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: 6q Permit Number:
Legal DescriptionParcel#
i r � oor ea o q. t. 9q.Ft
Valuation of Work$ T G 3J 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 Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval# FL. 1012Y.1
For multiple products use product approval orm
Describe in detail the type of work to be performed:
Property Owner Information: p
Name: I� S�CLr P Address: L �n n e�
City State EI-Zip 37 233 Phone tl 9- 3186
E-Mail or Fax#(Optional)
Contractor Information: n ee
tkO
Company Name: v �� 1 �ONS'� `c' Qualifying Agent: MP�t SSCt Yt te
CityState F(� Zip 32 Z 32
Address:
1204 l!' V t N Fax# 2276'37
Office Phone �� 3-1 1 9 Job Site/Contact Number (�S1'lZ
State Certification/Registration# C CL 132 -'7 1
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
that no
commenced
rior
issuance fis erm land that obtain
will belt to do the performed toork and installations as meet the standards of all lawstregulating construction in thirk or installation
jurrisdiction�This permit becomesothenull
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces,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 RNEY BEFORE RECORDING YOND TO OBTAIN UR NOTICE OF CONSULT H
YOUR LENDER OR ANA COMMENCEMENT.
e o Ovcertify
rt w h t I have read complied an whether cithis aiedlherein ornot.o Theesame to be true granting of a permitadoesct.not plresumelons to giveauaws thorityauthority tonances violateor cancelthe
typprovisions of any other federal,state, or local lav regulating construction or the performance of construction.
'X�
2
Signature of Owner Signature of Contractor
c d.1 tU r Print Name MJf.I. .. r ��
Print Name s�1 E=l ..........................................................................
..................................._ ,. ....................................................................-..............
Sw to and subscri ed befo a me Swo d subscribe f re e ,20 )�
Day o
20 �) thi ay of /
®Avl
is
tary Public E MY COMMISSION#DD926677
["SIRES September 20,2013 Revised 01.26.10
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