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130 SEMINOLE ROOF PERMIT CITY OF ATLANTIC BEACH II 800 SEMINOLE ROA rs ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number 13-00002548 Date 4/25/13 130 SEMINOLE RD Property Address . . • Application type description ROOF PERMIT Property Zoning TO BE UPDATED 5800 Application valuation . . . . ------------------------- Application desc reroof -------------- ------------------ Contractor Owner --------- FANNIE MAE GREAT WHITE CONSTRUCTION INC ONE WEST BANK FSB 4320 DEERWOOD LAKE PWY JACKSONVILLE FL 32216 888 WALNUT ST E PASADENA CA 91101 (904) 838-1659 ------ -----Permit ROOF PERMIT Additional desc 80 . 00 Plan Check Fee . 00 Permit Fee . • • • Valuation . . . . 5800 Issue Date • • ' . 10/22/13 Expiration Date . STATE DCA SURCHARGE 2 . 00 Other Fees 2 . 00 STATE DBPR SURCHARGE ---------------------------------------Paid------Credited Due Fee summary Charged ---------- ---------- - - ---------- 80 . 00 80 . 00 . 00 Permit Fee Total 00 00 00 . 00 Plan Check Total 4 . 00 . 00 . 00 Other Fee Total 4 . 00 00 . 00 Grand Total 84 . 00 84 . 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: 130 Permit Number: Legal Description O 311 t r %ec- 0 Parcel# Floor ea o t.q. q. t non-heated/cooled Valuation of Work$ Q9�_Proposed Work heated/cooled_ Class of Work(circle one): New Addition Alteration ��r Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one):installed? Residential If an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes N/A Florida Product Approval# 10%9�.Ll .t k For multiple products use product approval form Describe in detail the type of work to be performed: t-e,rooi Property Owner Information: Name: rr nr c ry-e,, Address: One we-at b"^1< City StateCR Zip °l►to t Phone qoq 31 S4o3 E-Mail or Fax#(Optional) Contractor Information: Company Name: Grr-+k Wti, Qualifying Agent: Address: 02o P,=rt.sc6a t.--ice City 3cw State V- Zip Office Phone ROH 8 3&•(V s` Job Site/Contact Number Fax# (S L L -146- 9q0 State Certification/Registration# 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. I 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 six p6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urnaces,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 application and know the same to be true and correct. All provisions of laws and ordinances governing this type gfYwork will 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 of any other federal,state, or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor �- Print Name f11�ctky.... `.. .c .................................................. Print Name .............. wy.....Stc.�skt-.� Sworn to and subscribed before me Swo . to and s bscribed b e this � Day of 9�c61 , 2013 thi >5 Da of A �� 2013 Notary Public ,ti e �, TRAVIS SLAUGHTER 3 * MY COMMISSION#EE 162194 ^► MY rCQMIs310N#DD Ievised 01.26.10 EXPIRES:January 22,2016 , EXPIRES:February 14,2014 m,�T' �•�` Bonded Thru Budget Notary Senku ' tT't111 I Bonded Thru Notary Public Undemdtere E�e«o NOTICE OF COMMENCEMENT �1 ©© (PREPARE IN DUPLICATEI Permit No. o�s�C> Tax Folio No. State of V I(Sh du County of Duval 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 0 31 i t- c-� r "Je a 61 Address of property being improved: l'IiI0rrii c1a�t %zln VL AS a cnt Lc'6�.tn General description of improvements: - Owner Mdc Address Civq, L_>rSE Qaic 4orr, CA g 110► Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address �+ - Contractor Gccc.k WtA;k elYl� C4C��on - Address 4437p 322',(, Phone No, 904-836-1659 Fax No. Surety(if any) Address Amount of bond$ Phone No. Fax No. Name and address of any person making a Ict.,i for the construction of the improvements. Name Address Phone No. _,_ _" __Fax No. Name of person within the State of Plorida,other than himself,designated by owner upon whom notices or other documents may be served: Name v 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 specked): THIS SPACE FOR RECORDERS USE ONLY OWNER Signed:_ ' ` `C DATE +.,30-11,he Before me this dW_" d h the County of Duval.State of Florida.h1is personally appeared —___�,� n,.c ti,u herein by Doc#2013103301,OR SK 16342 Page 2274, Mmselt herself a mrms that at statements and declarations herein Number Pages:1 are true and accurate ��ev rU� c,�J1UGHTER Recorded 0425/2013 at 01:17 PM, r° �P MY ComMIS M#EE 162194 Ronnie Fussell CLERK CIRCUIT COURT DUVAL EXPIRES:January 22,2016 COUNTY RECORDING$1000 No ery Public at Large.State of County of My commission e)oros,_ Personally Known-- ---_---- or Produced Identification.-