1679 SEMINOLE RD 04 ROOF PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002542 Date 4/24/13
Property Address . . . . . . 1679 SEMINOLE RD 04
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4200
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Application desc
REROOF
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Owner Contractor
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ANDERSON, CHRISTOPHER JAMES GREAT WHITE CONSTRUCTION INC
1679 SEMINOLE RD APT 4 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 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 . . . . 4200
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 REACH 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: Permit Number:
Legal Description Parcel �7
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 'A-too 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/pro ed structure(s)(�ircle one): Commercial
If an existing strucrurse,is a fire sprinkler system installed?(Circle on$e "i� N/A
Florida Product Approval# 10CILL-tio
For multiple products use product approval form
Describe in detail the type of work to be performed: z/o X�VOV/4 LAC 2&�
Propert-y Owner Information:
-Z� A�,
Name: d, )0�/fA� Address: AX _2e�1176
city ��IK6�h, .71ne,-
State/--ZZip _Phone
E-Maif or Fax#(Optional
Contractor Information:
Company Name:. .. Cwrxk �jvlvle_ CcuA61*"'Oualifying Agent: tvtWks sl��Ww�
Address: I 431c, pccmx�l%A L&V6ty__A_ ��io lk- 6e-,-'-- —State /�Z Zip
Office P91ane Job Site/Contact Number Fax#
State Certification/Registratiop I t3gioct,7
Architect Name&Phone# 848
C
Engineer's Name&Phone# )U/�—
Fee Simple Title Holder Name a ddress , Vr A4-
Bonding Company Name and Addr .s .�14
Mortgage Lender Name and Address
A lica is here made 0 an a e m d he work and in ta'ations as i ndca' or installation has commenced prior to the
ards a, r s thisjurisdiction. This permit becomes null
0 k i s eriod ofsix months at any time after
n or Od r u ap
f
!s ru 0 1 ctric
s
y r it t 0 t d to m tt Stan
'io t 0 't or p 0
p e t and ha a w k i e e rme
(6 m nt , or , t cto
I p uanc 0 a permi t w ' p
ss
d Vold work s not co "ced thin '�x
,,,I i t s s 0 'be secured rEe a W'dis, Pools, rnaces,Boilers,Heaters,
E I u M rs p r p r its_, t
f d de tand tha e a ate e
"k is c in ce
T 0 .e �t
a,ks and Air Con .ioners,et
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I herebl certify that I have read and examined this a pl know the same to be true and correct. Allprovisions oflaws and ordinances governing this
p, ication and
work will be com d wi whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany otherfe te, or local law regulating construction or the peifo�mance of construction.
Signature of Own Signature of Contractor
Print Name PrintName —Ve,
..........
..........................................
.............................
............41?10 I'll
% Stro
S tP and sub lbed ore me jA,. ra d-subscr e re me
Da 20
t�Iwisorn 1P!Dnaysof
WIN do
R GRAHAM
q47401
ary 14,2014
NotaiTPublic Febru
PIjbilc Undermters
lern otary
TMIJ01.26.10
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of 7)
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: (1A^4
2.A %I-&A. -70
--.e FL
-04 ^,
Address of property being improved: lice-11 Ro S642- :74 17-
4-0. A;- 'tlec.,L� L ?2-la Y 5-
General description of improvements:
-Wria
Owner
Address I V I4;a
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Ar/-Ow t 1AI;&*Ar ee
%Address A 1(7 P��IW4014 AWk
hone No. —Fax No.
.urety,(if any)
dress— Amount of bond$
Phone No. Fax No.
Name and address of any person maldrig a loan for the construction of the improvements.
Name A
Address /41or/
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 A
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
ciffierent date is specified):
THIS SPACE FOR RECORDER'S USE ONLY Signed: DATE
Before me this_day of i7�'e
County of Duval,State of Florida,has personally appeared herein by
JAYSON OACKS himself/herself and affirms that all statements and declarations herein
�Y. Notary Public -State of Florida are true and accurate
My Comm Expires Oct 7,2014
K,' Comrnis�ion # EE 33207 ---2—
Bc�mderi Tniouqii NallDnal Noiary Assn
NoUirgPublic S Coun
Doc#2013101712,OR BK 16340 Page 1858, Mk&mrW=e..Wirei:- //1 '4-2 4 VA
*irsonally Knom or
Number Pages:1 Produced Identification
Recorded 04/2412013 at 12:09 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10-00