468 Aquatic Dr 2013 roof .11 1 \ .
l
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
JF3
Application Number . . . . . 13-00002980 Date 7/01/13
Property Address . . . . . . 468 AQUATIC DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4499
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Application desc
REROOF 5 : 12 PITCH FL 5444-R4
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Owner Contractor
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WORKMAN DONALD L ET AL PREFERRED ROOFING & CONST ROOF
468 AQUATIC DRIVE 2232 DUNN AVE
WORKMAN BOBBY C RIS P.O. BOX 24668 32241
ATLANTIC BEACH FL 322333834 JACKSONVILLE FL 32218
(904) 751-0840
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4499
Expiration Date . . 12/28/13
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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 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No Tax Fulio N
State of 2FIEf 0Z County of
To whom ft 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
COMM,RNCEMENT.
Legal description of property being improved:
2
_ L.c:7 -
Address of property being improved: 'PS&(JI�)
A-7 }�LA N'T 1 C
General description of improvements: ``�� rz_0 rX
Owner Dpn)A'L D V3t>9—jL ak\4
Address y(CS 6631AA7 I C. L' 4Z--, T1 C
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor 1 0 k '
Address \A1
Phone No. tU1'�✓ t/D�� Fax No.
Surety(d any)
Address Amount of bond$
Phone No. Fax No
Name and address of any person making a loan for the constriction 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
j 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
i
iSection 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):
OWNER
Doc#201316523=,OR BK 16430 Page 808,
gnod: Cl-- C-- In the
! R ..
Number Pages: 1 ,fore me tiro day o1
Recorded 061271'2013 at 02:32 PM, —dy_of ouvd. of t:b da P°r°onalN'�"� herein by
Ronnie Fussell CLERK CIRCUIT COURT DUVAL {
rh5o U herself and aMmis that dl ststemeris and dedaroWnS herein .
COUNTY a true
RECORDING 510.00 000014q Notary Public State of Florida
' Sarah Keefer
My Commission EE 221354
1 Notary of
........... ... ..........
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 410-S ADUPT[ (�Z. Permit Number:'til
I
Legal Description 3�s— 1 8-a S—2� -r i 6A(Z. NS`�ceD
l#
Floor Area o Sq.pt
Valuation of Work$ cl �� Proposed Wor eated ooled non-heated/cooled 1'35(-0
(_c-r-0 C16
Class of Work(circle one): New Addition terati Repair Move Demolition pool/spa window/door
Use of existing/proiosed structure(s) (circle one): Commercial sidenti
If an existing structure,is a firesprinkler system nstalled? (Circle one): es No
Florida Product Approval#TL H-44i-4-P
For multiple products use product approval form
Describe in detail the type of work to be performed:
Property Owner Information: / '
Name:�t�c �c� l� �k r � Address: `I(_oc -A6)UAFTJ C 1Z
City,6'C�Ary-r G i�E .4-1 State F Zip Phone 3 -43_d�
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ( RQO COWTWA101 L LCQualif ing A ent:
2332 )�N l
Address: �—� City DfM U- State 'L Zip
Office Phone q�Y 1 —h, O` 4D job S'te/Contact Number Fax# tloi{ 1�1 (J l9 DD
State Certification/Registration# �Koa%
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 wdl be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void i work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of Ax )months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools, urnaces,Boilers,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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here, certify that I have read and examined this a plication 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 give authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.