30 17th St 2013 roof v�
CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002911 Date 6/20/13
Property Address . . . . . . 30 17TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4400
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Application desc
reroof
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Owner Contractor
-
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DOWLIN DIANE M & WILLIAM A ALL SEASONS ROOFING OF N FL
30 17TH STREET 3536 UNIVERSITY BLVD N # 187
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32277
(904) 591-4044
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4400
Expiration Date . . 12/17/13
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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 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 AL1, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PERMIT NUMBER Doc#2013157736,
Number Pa e,.1 OR 8K 16819 Page X88
NOTICE OF COMMENCEMENT Recorded
Ronnie Os/�/2013 at 11
IT
STATE OF FLORIDA
FLORIDA STATUTE 713.13 couNrY
Fussell CLERK CIRCUIT
RECORDING$10.00
COURT pUVgL
COUNTY OF CLAY
The undersigned hereby gives notice that improvement will be made to certain real property,
and in accordance with Chapter 713, Florida Statutes, the following information is provided in
the Notice of Commencement
1.E20
f property: (legal es ri ion of thgdg�bpe stree ad ss if availabl
]XV 6KOly
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2. General description of improvement: GY /� 101&1 z
3. Owner Information: ,
a. Name and address: a_ 911
O +
b. Interest in property: j2y&1yV
.c. Name and address of fee sim a titleholder(if other than owner):
4. Confrac or(Name and, dress): — S'
't dJ d' CPfi 'Pt�(
a.Phone number: b. Fax number:
5. Surety:
a. Name and address:
b. Phone number: c. Fax number:
d. Amount of bond: $
6. Lender: (Name and Address) 44
Allfi
a. Phone number: b. Fax number:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents
may be served as provided in S ction 713.13(1)(a) 7., Florida Statutes: (name and address)
a. Phone number: b.Fax number:
8. In addition to himself,Owner desi es
of to receive a copy of the Lienor's Notice as provided
in Section 713.13(l)(b),Floridagtatutes.
9. Expiration date of notice of commencement (the expiration date is one (1) y fr the date of
recording unless a different date is specified)
�e of Ovmq
Print Name
Sw �� (or ume ) and subscribed before me this day of �_i 20/3 by
(Name of person making statement).
LINDA KAY REDO
* * W COMMISSION I DD 900672
Seal: EXPIRES:August 2,2013 Signature of Notary- State—of Florida
+r'�of r►� Bonded ilru Byyd Nahry 8«rbw
Personally Known OR Produced Identification/Type
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1 �%_lG dPermit Number:
Legal Description
AaAc I#-
Floor Area o �7p Sq. q t
Valuation of Work Proposed Wor heated/cooled A non-heated/cooled
Class of Work(circle one): New Addition Ite pe;a* Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire spri kler stem installed? (Circle one): Yes No N /A
Florida Product Approval # Lt
CA
For multiple products use produlFflapproval form
Describe ilydetail the type of work to b e ormed: aP ;CMed[
Property Owner Information: rh
Name: A dress:
City / %�� B,/G State/`' Zip Phone
E-Mail or Fax#(Optional)
Contractor Information: `
crr i d
Company ame: P rG'�Qualifyin AgeORP? 7
Address: City AX /� State Zip
Office Phone �' Job / o ct Number O iii2
Fax# /Y
State Certifica ion/Registration# GL
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(ti)months, or if construction or work is suspended or abandoned for a_period of six 6)months at any time of er
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Healers,
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 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 specijP h ein or not. The granting of a permit d resume to give ity to violate or cancel the
provisions of any other federal.stat�)r cal law sting construction or the performance of c truction.
Signature of Owne Signature of Contrac or
'n
r.p
Print Name L ��W L //✓ Print Name �w .........r...........................................................................
.. .................................................................................................................
Sworn to and subscxd*beO before me Sworn to and subscribed_before me 201
this/�` Day of,,/ .20/ 1 this Day of ���/�[
i
Y
Pod
% _'�� P
Notary Public * * MY COMMISSION#DD 900612 MYI
COMMISSION i g
o� EXPIRES:August 2,2013 ' * EXPIRES:August 2,2013 Revised 01.26.10
+'FOF��� Baided T1w Btdpet Netary Setvioea �',����A� kWed Thu Budpet tiohip W*u