1817 Live Oak Ln 2013 Roof CITY OF ATLANTIC BEACH
•� J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002693 Date 5/20/13
Property Address . . . . . . 1817 LIVE OAK LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 15000
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Application desc
re-roof 10124 . 1
-----------------------------------
Owner Contractor
--------------
----------
BACHER WILLIAM C & AUGUST M ROOF IT RIGHT LLC
2175 KINGSLEY AVE SUITE 207
1817 LIVE OAK LANE
ATLANTIC BEACH FL 322334509 ORANGE PARK FL 32073
(904) 541-1191
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF plan Check Fee 00
Permit Fee . . . . 125 . 00 15000
Issue Date Valuation . . .
Expiration Date . . 11/16/13
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--------------------------------------------
2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
_ ________ ---
Fee summary Charged
Paid Credited ----Due---
. 00
_ _ ----------
----- ----------
- . 00
Permit Fee Total 125 . 00 125 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00
Grand Total
129 . 00 129 . 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: T L
l- Permit Number:
Legal Description Parcel# q. t
oor ea o q. t.
Valuation of Work$ ` Proposed Work heated/cooled 336Z non-heated/cooled
_iW_
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proosed structure(s) circleone):installed?
Residential
If an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes No N/A
Florida Product Approval# L /01 `1
For multiple products use product approval form
G 4r
Describe in detail the type of work to be performed: r -
Property Owner Information:
Name: �� �`� `j Y r Address: _
City /A4 W., <<- ]3r uc State&-Zip 3 Phnne (o
S
E-Mail or Fax#(Optional)
Contractor Information: II ,p
�i n Qualifying Agent: ri ►'� l `�r r C-71Company Name: µ, State L� Zip ,
Address: k 'C,
City
Office Phone
Job Site/Contact Num er - �! Fax# y
C 1
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
that no work or
stallation
commenced
Applicationis
ermitand hat al work obtain will be performed t ork and meet therstandards of altallations as l laws regulatinicated I g construction in thisjurisdiction. his permit becomesrior othen
issuanceull
and void i permit
is not commenced within six(6)months, or if construction or work is suspended or abandon dfor a_Ptime after
ri P flsiXP6months
ons goners,Heaters,
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbin ,Signs, W
Tanks and Air Conditioners,eta
WARNING TO OWNER:iO YFTO RECORD
CE F
A NOTICE OF
COMMENCEMENT MAY RESULT IN OUR PAY NG TW OR IMPROVEMENTS
CONSULT
TO YOUR PROPERTY. IF YOU INTEND BEFOBTAIN D�ING YOUR NOTICE OF H
YOUR LENDER OR AN ATTORNEY MMENCEMENT.
1 here certify that I have read and examined this edltherein orot.ow the sam to be true The granting of a per does nd cnot pt. lresume to girovisions ve authority to Vi�etegor eancovernig this
III work will be complied with whether. ��11ee ormanee ofconstruction. ""S
provisions of any other federal,state,.or t6eal law re lating co tru ' a� .
Signature of Owner Signature of Contractor
„
,` ' .........
-t
Print Name _ ......... .................................................................. .. ..�
Y/ kt r ..y.
Print Name i- .. . -'- _
...�.. , .. a....
53
Sworn to and subscribed before me
Sworn to and subscribed before mem 20 �m
7 a 20 this O'Day of
�
this U Day of 0
`7 rn N
C5
No
Revised 01.26.10
0
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. _ ___ Tax Folio No.
State of ___ County of
To whom it may concern:
The undersigned hereby ,. ` . . •.. you that improvements will be made to certain real property, and in
accordance with Section 713 of ,he Florida rtatut, the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:
r V 3 -) 23.
Address of property being improved:
L, k� K
i
General description of improvements:
Owner G G t
Address /917
L FIs �k Lk n
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
Contractore 73
Address o� 17 S ^ "' � y�t—
�
Phone No. Fax No. J
Surety (if any)
Amount of bond $
Address
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
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):
OW R
THIS SPACE FOR RECORDER'S USE ONLY DATE a•: _
Sign
Before e / a
County of Duval,S to of Florida,has pe orally appeared
her i 4 o
himself/herself and affirms that all statements and declarations herei
-- -- are true and accurate z W,,m
Doc#2013127285,OR BK 16376 Page 244, a o
Number Pages: 1 m
Recorded 05-20/2013 at 01:27 PM, m
Ronnie Fussell CLERK CIRCUIT COURT DUVAL01
x
COUNTYarty of - u
RECORDING$10.00 Notary Pu is at L e tate C
My commission expires: or
Personally Known
Produced Identification ��