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820 Hibiscus St 13-00002798 Roof E. I CITY OF ATLANTIC BEACH j r) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 .= INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002798 Date 6/05/13 Property Address . . . . . . 820 HIBISCUS ST Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4300 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SMITH NANCY LEE ET AL EMPIRE ROOFING SALES & SERVICE C/O DALE M SMITH 2806-1 GIBSON RD 3665 SOUTH NEEDLES HWY 31F JACKSONVILLE FL 32207 LAUGHLIN NV 89029 (904) 334-1661 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4300 Expiration Date . . 12/02/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- 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 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: A ! _ e �P IT e Legal Description IS -34 S - qrce oore o q. t. q• t Valuation of Work S 36 O Propos Work heated/cooled 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). es o N/A Florida Product Approval # For multiple products use product approva orm Describe in detail the type of work to be performed: rctv IQ c Property Owner Information: Name:___0 Address: 3 U l � City State�RZip 2A2 Phone - -Lt 32 E-Mail or Fax#(Optional) Contractor Information: Company Name: � 1� 04�(Ml Quali ng Agent: Address: 5 H d ' City State Zip 2� Office Phone T1 t©n Z Job Site/Contact Number g 0 L(-.3„3K&6( Fl V77 State Certification/Registration# C-CC. 13 a t,00: — 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. 1 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 thisjurisdiction. This permit becomes null and work void if o work is commenced.of Icommenced within six understand that separate permits muor st be secuconstruction or work red for Elecer trical IV or Plumbing, Signedns,oi aWeI1s�P of six months Boilers,time 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 BEOR RECORDINGMENTYOUR NOTICE OF COMMEI hereb certify that I have read and examined this application 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 specified herein or not. The granting of a permit does not presume to gc 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 ct �� Print Name Print Name ._ ...e.,r?..................... Before Before me p this ay of 2013 this `Day of 20 `,aV STEPHANIE M.SWIs94FY AWN (ON# UbI1C "CO�l SSION#DD•q7�7 ota Public -.�;�.., c EXPIRES October 05,201 4 am EXPI ry }� JId 14*M.NOTARY FebWO Ajumme (407)'3.9a-0163 FlotidallotarySery ce tom swum Assoc.Co NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of l County of 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: 13- 3 u P`R' — ?:I r Address of property being improved: urg, ' 2Z— General description of improvements: _ n— O Owner Address U Owner's interest in site of the improvement Fee Simple Titleholder(f other than owner) Name Address Contractor N C� Address &4 s a 7 Phone No. q r o n Fax No. Surety Of any) Address Amount of bond$ Phone No. a N 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 an himself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Rw No. In addition to himself,owner designates the following person to receive a copy of the Lienoirs Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option. Name Address Phone No. Fax ko. Expiration date of Notice of Commencement(the expiration date Is one(1)year from the date of recording unless a different date is specified): �3 THIS SPACE FOR RECORDER'S USEONLY O TER /� (adq: lk ATE e thistlayof o in the Cfppuval,State of Flo hes pe Wally appeared Doc#2013141639,OR BK 16396 Page 563, Nth t STEPHANIE M.SWEENEY Number Pages:1 hlmsetrl herself andIffMs that all statements and declaratl ;+, MY COMMISSION#EE03226 are true and accurate Recorded 06i0412013 at 03:25 PM, EXPIRES October 05,2014 Ronnie Fussell CLERK CIRCUIT COURT DUVAL ,°",!t••' (407)398-0153 FloridalloteryServiee.cam COUNTY RECORDING$10.00 No P�J= ge,State L only of rmy comires:Personaor Produced Identification