119 Jasmine St roof 2013CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . .
13-00003103
Date 7/19/13
Property Address . . . . . .
119 JASMINE ST
Application type description
ROOF PERMIT
Property Zoning . . . . . . .
TO BE UPDATED
Application valuation . . . .
----------------------------------------------------------------------------
6500
Application desc
REROOF
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Owner
Contractor
------------------------
CORNER LOT PROPERTIESLLC
------------------------
LEAKBUSTERS LLC
ROOF
3721 DUPONT STATION CT S
6040 GEORGEWOOD
LN W
JACKSONVILLE FL 32217
JACKSONVILLE
FL 32244
(904) 778-4377
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Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 85.00
Plan Check Fee
.00
Issue Date . . . .
Valuation . .
. . 6500
Expiration Date . . 1/15/14
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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 85.00
85.00 .00
.00
Plan Check Total .00
.00 .00
.00
Other Fee Total 4.00
4.00 .00
.00
Grand Total 89.00
89.00 .00
.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of 1 (,N4r. Q County of Duval
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: 18-34 38 -2S -29E SEC H ATLANTIC BEACH LOT 6 BLK 88
Address of property being improved: 119 JASMINE ST Atlantic Beach FL 32233
General description of improvements: Roof Replacement
Owner CORNER LOT PROPERTIES LLC
Address 3721 DUPONT STATION CT S JACKSONVILLE, FL 32217
Owner's interest in site of the improvement Owner
Fee Simple Titleholder (if other than owner)
Name
/ Address
I
`� Contractor Leakbusters LLC
Address 6040 George Wood Ln W, Jacksonville, FL 32244
Phone No. 904-778-4377 Fax No. 904-772-6682
Surety (if 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 _
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 Lienor's Notice as provided in
Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option).
Name Leakbusters LLC
Address 6040 George Wood Ln W, Jacksonville, FL 32244
Phone No. 904-778-4377 Fax No. 904-772-6682
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a
different date is specified): -------------------30 Days ---------------------------- I ------------- ---------
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: J DATE � I R 13
Before th day of n 1 n «, k .. in the
Doc # 2013187305, OR BK 16460 Page 713,
Number Pages: 1
Recorded 07/19/2013 at 11:58 AM,
Ronnie Fussell CL RK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
by
hlmsle f4brselr and affirms that all statem8nts and declarations herein
are true and accurate
N tary Publi urge, State of o�-4a County of
My commiss xpirr
Personally Knownv 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: 119 Jasmine St Atlantic Beach, FL 32233 Permit Number:
Legal Description 13-34 38 -2S -29E Sec H Atlantic Beach Lot 6 Blk 88 Parcel # 170850-0000
oor Area of Sq.Ft. Sq.Ft
Valuation of Work $ QSUO Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Mo molition pool/spa window/door
Use of existing/proposed structure(s) (circle one):Commercial _KeK side.
If an existing structure, is a fire pr><nkler system installed? (Circle one): Yes No N /A
Florida Product Approval # jrZ1j)(1-7q Fe
For multiple products use Oroduct approvaform
Describe in detail the type of work to be performed: t rL
Property Owner Information:
Name: Corner Lot Properties LLC Address:3721 Dupont Station Ct S_
City Jacksonville State FL—Zip 32217 Phone 904-337-0609
E -Mail or Fax # (Optional)
Contractor Information: V
Company Name:
Q 41(b Lt S t L VC . Qualifying Agent: C ��t C'- S'l- -ie4 (C ,--
Address: (0 ' & r �./ a-;, L City ) c Ic 1 ^ ✓ t State F! A . Zip
Office Phone -� "1 Job Site/ gontact Number 3 3 - f`S.�y Fax # o �1-17 D - 4 to �
State Certification/Registration # C r r- 1251 Y S 1 Z,
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 (6) months, or if construction or work is suspended or abandoned for a period of sixp6) months at any time after
work is commenced. 1 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.
1 hereb c
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 owork 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, sta , or loc l law egulating construction or the performance of construction.
Signature of Owner Signature of Contractor C a-
Print Name.
..�..Y...I...ab..�:�ll ! 1 ► ...e.,
Sworn, �and subscnb
'je before me
thi? ► C� Day of �yl l v� , 201
KELLY PLEWNIAK
** MY COMMISSION # EE 882228
0Q?�F
EXPIRES: March 11, A2017
�19F`OBonded Thru Budget Notary Services
Print Name �,�a..,r..i.c..............I... r-�.....
Sworty,Q andsub crib b fo me
thi y o 120
Nota u is
�MIRLEYL Revised 01.26.10
F+_ ''" (1,OMMI8SION ##DDp� 60 j �%
�ItPIRE6, February 14, 2014 / /d / — 0
_edI„ Notary Publk Underwriters l