1580 Beach Ave roof 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002958 Date 6/26/13
Property Address . . . . . . 1580 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9100
----------------------------------------------------------------------------
Application desc
REROOF
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
KOHL MARK ALTA LAND DBA
1580 BEACH AVENUE NORTH FLORIDA ROOFING & REPAIR
ATLANTIC BEACH FL 32233 13758 PLEASANT VALLEY DR
JACKSONVILLE FL 32225
(904) 219-1812
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 9100
Expiration Date . . 12/23/13
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 104 . 00 104 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Doc # 2013163173, OR BK 16427 Page 1346, Number Pages: 1 , Recorded
06/26/2013 at 10:51 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF CIPAMNCEMENT
(PREPARE IN DILIPUCATF)
PemIt No. TaX Folio MD.
Atato of Countyof 1)11"'401
to whom it may conoorn:
The undersigned hereby Informs you that improvements will be made to certain real prv!porty,and In
socardanoo with,%otlore 713 of the Florida Statut**,the following informatlot,Is stated In tNs NOTICE oF
COMMENCEM90.
Legal dawriptlon of property being Improved;.
Address of propertybeirin Improved:
General descilption of Improvemente;
Owner--—----- ko An:
Addro--Jji��d .
owner's interout in alto of the improvarmnt
Fee Simple T109holdor Of other than owner)
Name
Addre&s:.
contractor
Addroes
Phone No,
F No.
SurotY(It-Y)
AddrSas-- Amount of bond$
Phone No. Fax No
Name arid addreW Of SnY PmOn makIng a loan for the construction of the Improvements.
Name—------
Addies-3
Phone No. rox No.
Name of pemn within the Stale,of Florida,other than himoolf,�adomtod by owtw upon whm noticoo or other
dw,umwis rnay be tieryod;
Name -------------——------------—- --------------
AddIrav;
Phone No. Fax No.
In addition to Hiniself,Omer designates the following pars6n to recetvo a copy of the Llertofs Notice as proVlftd It)
Section 7JI.nis(2)(b),ROdd8 StatIL1106.(F11I In at Owner's DP90n).
Name —--------———-----------—--
Addrm
Phone No. Fax No,
EVIralan date of Nolloa a comrnommmant(the expiration dpite is am(1)year from the date of rouording unless a
Morent date tz,rporiffled):
—THIs—spAiCE FOR RUCOR Eft'S US9 ONIX ER
ke—(,/I z
Wo Wa
County of 0
Ord ---AjeTS1n by
rn 0
M and dooleralons hcrein
we M M a
do
C.Mww bxpbm!— 0i — 114 or
P.0notly vin
plod4i
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel# Sq.Ft
Valuation of Work $ 0 0 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Repair Move Demolition pool/spa window/door
(2��) 1
-d structure( ie): Commercial Residential
Use of existing/propose s) (circle oi
0
If an existing structure, is a fire!Vrinkler system installed? Circle 0�;� N/A
Florida Product Approval# /111;11Z/I-
For multiple products use product apprnV Morid
Describe in detail the type of work to be performed: R&Y-40- vec
Property Owner Information:
Name: Address: 1400 19C,22C
C,
ity Rmch State_Zip Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 0 qeN Qualifying Agent:
Address: y0J00,Q(_/2(+ blafi&4 VC City State Zip
7�_ Job Sit&iZontact Number Fax#
Office Phone 21
State Certification/Registration# CC 1 ,232-122 -39
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 thisjurisdiction. This permit becomes null
and void ff work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period ofsixp6,)months at any time qfter
work is commenced. I understand that separate permits must be securedfor Electrical work, Plumbing, Sikns, Wells, Pools, 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 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
anting of a permit does not presume to give authority to violate or cancel the
work will be complied with whether specified h rein or not. The gi
prousions of any otherfederal,state, or local law re ting construction or the pe�formance of construction.
Signature of Owner Signature of Contractor
PrintName P ................................................................ Print Name ...............M ............................................................................
. .................Mw*
Sworn to and ubsc ibed before me Sworn t and su scribed before me
this J_D this Day o 200
D y of LM4 e-
before Me
V
ry L N ar Public
Notary lic JACALYN ....... I
JACALIV(WHOPM6.1
My COMMISSION EE849091
My COMMISSION#EES49091
EXPIRUS NOYOMbOr 05-"18
EXPIRES November Of 2018
my
EXI
07
nS-0153 r 3*0153 coo