1050 Seminole Rd 2013 roof lv�
CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002581 Date 5/01/13
Property Address . . . . . . 1050 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 19640
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Application desc
REROOF
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Owner Contractor
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GEARHARD, JOHN D HAGERTY CONSTR. AND ROOFING
1050 SEMINOLE RD 3749 QUINBY ISLAND CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 819-5545
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 150 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 19640
Expiration Date . . 10/28/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 25
STATE DBPR SURCHARGE 2 . 25
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- --------
Permit Fee Total 150 . 00 150 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 50 4 . 50 . 00 . 00
Grand Total 154 . 50 154 . 50 . 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. 171974-0000
State of Florida 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: Lot #7, Block#7, Unit#3, Selva Marina
Address of property being improved: 10550 Seminole Road, Atlantic Beach, FL., 32233
General description of improvements: new asphalt Shingled roof(re-roof
Owner John Gearhard
Address 1050 Seminole Road, Atlantic Beach, FL., 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Hagerty Construction&Roofing,Inc.
Address 12850 Winthrop Cove Drive,Jacksonville,Florida,32224
Phone No. 904-992-9960 Fax No. 904-992-9961
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
a
Phone No. Fax No. C m
LU
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a z
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY NER
Cg1��/
Signe . OStte
DATE �� 1 7 Z
Before is ay of In the Z tU
County of vaf Florida, as personally appeared Q CC
John Gearhard herein by
Doc#2013108191,OR BK 16349 Page 2329, U. L1
Number Pages:1 himself/herself and affirms that all statements and declarations herein U.
are true and accurate
Recorded 051;01/2013 at 08:49 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL /
COUNTY LJV C
RECORDING$10.00 ,
Notary u c at Large.Stat Florida County of L)w� �y- g
My com i ion expires: "'°°°°
Personally Known or
Produced Identification
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1050 Seminole Road Permit Number:
Legal Description Lot 0Block#7 Unit#3 Selva Marina Parcel#171974-0000
Floor Area ot Sq.Ft. Sq.Ft
Valuation of Work$ $19.640.00 Proposed Work heated/cooled 6400 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# 10124.1
For multiple products use product approval form
Describe in detail the type of work to be performed: new asphalt shingled roof(re-roof)
Property Owner Information:
Name: John Gearhard Address: 1050 Seminole Road
City Atlantic Beach State FL Zip 32250 Phone 904-608-0813
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Hagerty Construction&Roofing, Inc. Qualifying Agent: Quin J. Hagerty
Address:12850 Winthrop Cove Drive City Jacksonville State FL Zip 32224
Office Phone 904-992-9960 Job Site/Contact Number 904-591-4354 Fax#_904-992-9961_
State Certification/Registration# CCC 057779
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 pade 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 tl work will be performed to meet the standards of all ws regulating construction in thisjurisdiction. This permit becomes null
oid fork isommenced within six(6)months, or if construction or work suspended or abandoned for a period ofsix(6)months at arty time after
k is commenced. !understand that separatepermits must be secured for Electical Work, Plumbing,Signs, Wells,Pools, t'urnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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 here b certify that I have read and examined this plication and know the same to be true and correct. All provisions of s and ordinances governing this
type o0 work will be complied with whether specified herein or not. The granting of a permit does not presume to uthority 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 C ctor
Print Name Jam. Print Name V... .... ... ......................................
Sworn o and subscribed before me Sworn to and subscribe re me 20
this Day of 20 tj this ZA_Day of
Notary Public TIFFANY GARDNER Notary blic .---
:; , , es0�'M gER
MY COMMISSION#EE219875 .+: MY COMMISSi• .I 19875
EXPIRES August 06.2016 EXPIRES August 06.2016
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