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270 Belvedere St 2013 roof (2) CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003144 Date 7/25/13 Property Address . . . . . . 270 BELVEDERE ST Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5640 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ TAYLOR, ROVERT S EXCEL ROOFING CONTRACTING 270 BELVEDERE ST 5722 DUNN AVE ATLANTIC BEACH FL 322334109 MIDDLEBURG FL 32068 (904) 463-3438 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 5640 Expiration Date . . 1/21/14 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 84 . 00 84 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. NO'T'ICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No, State of L County of Tb� om It may concem: The undersigned hereby Informs you that Improvements will be made to certain real property,and in accordance with Section 713 of COMMENCEMENT. the Florida Statutes,the following Information is stated In this NOTICE OF Legal description of property being Improved: Address of property being improved: t V t: - T nn FL General description of improvements: K E- FjP FLc, C- Owner Addressct�2 — Owners interest in site of the improvement f L4-, CA Fee Simple Titleholder(if other than owner) Name Address Contractor -"5c'c,77- e,Q K S�� L Xi' / ter,F'r r16 14 rt lei � Address 41y u k 46"E', FL.- Tim l f Phone No. 4 31-7& Fax No. Surety of any) Address Amount of bond$ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address �J 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 Lienors Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owners option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date Is o (1)year from the date of recording unless a different date Is specified): THIS SPACE FOR RECORDER'S USE ONLYO ER Signed,14tW. DATE Before A this _day in the Cou f Duval,S d e asp rsonally appeared 4L herein by Doc#2013192980,OR 3K 16467 Page 2038, himself/herself and atonia that e9 statements and declarations herein Number Pages:1 are true and accurate j. Recorded 07/25/2013 at :14 PM, % ALLIE FAIN Ronnie Fussell CLERK CIRCUIT COURT DUVAL NOTARY PUBLIC COUNTY STATE OF ELQRIDA RECORDING$10.00 Notary Public at Large,State of � unt� My commission expires! WS 10RW Personalty Known or Produced Identification BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: a,►?0 S T" Permit Number: Legal Description Parcel# Floor Area of sq. t. Sq.Ft Valuation of Work$ -&LSEU Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Mo olition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial esidential If an existing structure,is a fire sprinkler system installed? (Circle one): es o N/A Florida Product Approval# IS-31 For multiple products use product approval orm Describe in detail the type of work to be performed: PEy oi&t ' Fz_g T XGbr' yjrt-/c, 9,C-7c �X 6 -4AI5n 4j_ irVaVCi Z50 ,l714c-1- Aw".oK,d &,4tle k6T- Property Owner Information: Name: " toe Address: a,70 ,�FLiE9t5kc 5->L City_ P roc 4 State LZip s} 3 Phone E-Mail or Fax#(Optional) Contractor Information: /��I Company Name: ��cC��— �CooFinf� L1qati Tr#4-c7yoc5 g=tnC Qualifying Agent: '©7T So��NSE ti Address: 3`7)-X ,aura K 14yt City (<SoKu kLC,6 State Zip 3 1 Office Phone 01- N,&5 Job Site/Contact Number -il 3-3 e(3 f- Fax# State Certification/Registration# C'C C 13 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 cert that no work or installation has commenced prior to the issuance of a permit and that all work wt11 be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 16)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, Furnaces,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 hereby certify that I have read and examined this application and know the same to be true and correct. All provisiWonor antes governing this type o work will be complied ith whe er specs ied herein or not. The granting of a permit does not presume ty violate or cancel the provisions of any other federal tate, or ocal law regulating construction or the performance of construction PLS(p5,2 d- Signature of Owner Signature of Contrac r Print Name (Zp Print Name © / . ........`jam..........�.o..R.................................................................... Before'} F Be this d-'�t'- Day of 201) this a of Jv 200 ALLIE/�X&,__ �'�NOTARYAIR PUBLIC \ Notary Public STATE OF FLORIDATic TENNI w Comm#EE071936 .: MY COMMISS N Y FF 011480 Expires 3/8/2015 Via: EXPIRES:April 24 2017vised 10.24.12 ?,....., Bonded Thru Notary Pubk Unrbmbrs