1679 SEMINOLE RD 01 ROOF PERMIT IL
�51 ')U
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002539 Date 4/24/13
Property Address . . . . . . 1679 SEMINOLE RD 01
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4685
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Application desc
REROOF
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Owner Contractor
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REEG, RONALD J GREAT WHITE CONSTRUCTION INC
5 LYNNEFIELD CT 4320 DEERWOOD LAKE PWY
MEDFORD NJ 08055 JACKSONVILLE FL 32216
(904) 838-1659
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4685
Expiration Date . . 10/21/13
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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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 16 7q ;Q�, */ A-71_,QvT1c. Ee-11 . -Permit Number:
Legal Description Floor Area of Sq[.Ft. Parcel# Sq.Ft
Valuation of Work$ 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 Residentia
(gaik N /A
If an existing structure,is a fire sprinkler system installed? (Circle one)r:
Florida Product A proval # k13161%A1 L(o
For multiple prosucts use product approval form
Describe in detail the type of work to be performed: 7k-AIZ 0,Q)
Property Owner Information:
Name: -Address: K-L'V,V'X�ek�
city —State.FiZip 233111,z, Phone S�5,1
E-Mail or Fax# (Optional) rv!ve!��&qalrt)armel� /L -fleT
Contractor Information:
Company Name: C,%rqcA- viv-��c Qualifying Agent: -V'y-c,\Ao
Address: �a�o kcuc city dw _!Ttate T1- zip
Office Phone q1te-t 831-k1.S'1k Job Site/Contact Number Fax 4
State Certi ficati on/Regi strat ion #
Architect Name& Phone#
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
�Ipvlication i's herellymade to obtain a permit to do the work and installations as indicated 1 certify that no work or installation has commenced prior to tile
issuance oJ�aopermit and that all work will be Performed to meet the standards of all laws regulating'construction in this jurisdiction. Th mit becomes nuil
,ind void f rk is
not commenced within six(6)months, or if construction or work i's suspended or abandonedfor a period of six(6)in at any time after
work is commenced. I understand that separate permits must be securedfor Electrical Work, Plumbing,Signs, Wells, Pools, Airnaces, Boilers, Heaters,
Tanks andAir 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 hereby certify that I have read and examined this application and know the same to be trite and correct. .411 provisions of laws and ordinances governing this
iyoe of work1will 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 qf any otherftderal,state, or local lawregulating construction or the per/brmance of construction.
Signature of Owner Signature of Contractor J.
Print Name Print Name —kizvks
................................................................. ..............................-................. ...........................................................................
lar_- MP
Sworn to and sub cribed lAf4o r me Swop t
this yt�ay of 11��_o P-M 20 1 th* Z�
I , 20
My MMIS N#DD957760
EX RES:
14
Notary Public Notary Public State o lo'da
Raeann Keating
V,4 My Commission EE 1653
.OF , Expires 02/0412016
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
'T
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: VI-14 2. +6.'A-J(J- L"4-A lk;�u
AP R-e + 2- C, 0 4�t r.) ev. 4-5 '--e C
SA- Cyr�j�OA FL
Address of property being improved: -'-r Z
FL
General description of improvements:
Owner
Address I
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor A-14W Ile e~,
J/-W/w9W/jN
Address ///7
-,Phone No. Fax No.
S ty
urety
(if any)
dress Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the Improvements.
Name A
Address 1%."14
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 044
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 ER
Signed: DATE
Before me this_day of I a
County of Duval,State of Florida,has personally appeared
JAYSON OACKS herein by
""jky himself/herself and affirms that all staternents;and declarations herein
Notary Public -State of Florida am true and accurate
My Comm Expires Oct 7.2014
Commission # EE 33207
0
8(,ndeo Miwign Nalfonal Notary Assn
NF;o
ersE�b=fic State%P--L County9f ZV4---1 f
Doc#2013101712,OR BK 16340 Page 1858, kofelxgpiores�':- /1,7 V--,Z '-'14/11
Known or
Number Pages:'I dentification r/
Recorded 04/24/2013 at 12:09 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00