332 3rd St 2013 roof 1
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002577 Date 4/30/13
Property Address . . . . . . 332 3RD ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 11615
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Application desc
reroof
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Owner Contractor
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SWANN STEPHEN & KIMBERLY JACK C. WILSON ROOFING CO.
332 3RD ST 4522 ST. AUGUSTINE RD.
ATLANTIC BEACH FL 322335232 JACKSONVILLE FL 32207
(904) 396-1546
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 110 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 11615
Expiration Date . . 10/27/13
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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 110 . 00 110 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 114 . 00 114 . 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: �* 3Permit Number:
S_(Oct 16- -129 tt L
Legal Description Lr- 1 i _ e l o-f+ 13(_K 4 Parcel# (cl 1) a• ' �- ( �r
Floor Area of St, q.Ft
Valuation of Work$ (S 0 Proposed Work heated/cooled OOO. C t, non-heated/cooled
Class of Work(circle one): New,,` Addition Alteration Repair emolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residentia
If an existing structure,is a fire sprinkler system installed? (Circle one): es N/A
Florida Product Approval # 7
For multiple products use product approval form aJ-,�+1aA()rCL_1
Describe in detail the type of work to be performed: Q k ��
S ; r 0 SIS` l-e-S
Property Own r Information:G� 60 \ ,p
Name: ddress• VV>� 33Z �-
City Sta Zipne
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: o } Qualifying Agent: V (-() l� Vo S S
Address: 45f;k, 5t v t - City j l l� _ State ( Zip 3a,-14 r-)
Office Phone 4 0+f- 59 b-l Job Site/Contact Number(3[6L(-S9 I-5'756 Fax#
State Certification/Registration# CC C og-9 3 5�
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 cernfy that no work or installation has commenced prior to the
issuance of a permit and that all work wtll 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 sus ended or abandoned for a_period of sax 16)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electric 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.
I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether sped ted 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 c Signature of Contractor
`Print Name �::z........ ,..:. ! .1!.!........................................... Print Name /................OJ'................................................................
Sworn to and subsc 'bed before me Sworn to and subscribed before me
this Day of 20t'' this f S Day of _ 2013
r
Notary PubVPub ' 44280 Notary Pu L26.
commissionKDD 8 gyres �'`�--y ission Exp ommM comm 3 2013ed 0J13sDecember 0 oF
�•
Doc # 2013107636, OR BK 16349 Page 427, Number Pages: 1 , Recorded 04/30/2013
at 03:19 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
°e-m't No. Tax Fotto No.
State of Florida,County of Duval
THE UNDERSIGNED hereby give notico that the improvement will be made to certain real property in accordance will',
Chapter 713,Florida Statutes,the following information Is provided In this Notice of Commencement.
DescrLL
tion of pro rty(legal description of property and addtgss if available): p�� 3 'J�
S bpi 1� a5 a9 cAo�nt C3cr , w1la L
Gcn1 Descriptiof improvements
c n p
3. Owner Information:'" (/v t/ �d233
a)Name and Address,: 112G1
b)Interest in property:
c)Name and address of simple titleholder(if other then owner):
:. Contractor Information:
Name and Address: SACK C.WILSON ROOFING
Phone Number: WIL at Augustine •0
JeCKSOVIII8, 07
Surety Information: (904)386-.k546
a)Name and Address:
b)Phone Number:
c)Amount of Bond:S
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Pcrson within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13(1)(a)7,Florida Statute:
P)Name and Address:
b)Phone Numbers of Designated Person:
S. In addition to himself/herself,Owner designates of_______ to receive
a copy of the Licnor's Notice as provided in Section 713.13(1)(b),Florida Statutes.
a)Name and Address:
b)Phone Number of person or entity designated by owner.
9 Expiration date of Notice of Commencement(The expiration Sate is one(1)year from the date of Recording unless a
different date is specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART
1. SECTION 713.13• FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMEN MENT.
` Signature of 0 wner's Authorised Officer/Director/Partner/Managg. Signat6ry's Printed Name k Title/Office
'c
The foregoing instrument was acknowledged before me this V day of ,201 ,by
as for
Mme�e o, et-son
(Authority Type.i.e. tar Anomey am Pany ns ent was Execute or)
CHRISTOPHER VOSS NOTARY PUBLIC,STATEQFFLORIDA_
Commission N OD 944280 Print Name:
My Commission Expires
a;;,,• December 03, 2013 0 Personally Known
0 Identificat=fType:
Verification pursuant to Section 92.525,Florida Statutm Under penalties of perjury,I declare that I have read the
foregoing and that the facts stated in it are true to the best of my imowledge and belie /7
3I acorn]Person Stoibg Above