375 1ST ST 2013 ROOF CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003134 Date 7/24/13
Property Address . . . . . . 375 1ST ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3500
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Application desc
reroof
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Owner Contractor
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KERBER FREDERICK A A CROWN ROOFING INC
375 1ST ST 2159 ST JOHN' S BLUFF RD S
ATLANTIC BEACH FL 322335227 JACKSONVILLE FL 32246
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3500
Expiration Date . . 1/20/14
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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 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: ��� _ fir ,�����-�
ACA4
1?4 ermit Number:
Legal Description &12 _2 pG� G Parcel#
Floor Area o �Sq. t. q. G�
Ft
Valuation of Work$ Proposed Work heated/cooled� non-heated/cooled4
Class of Work(circle one): New Addition teration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed? (Circle one . No
Florida Product Approval #��y,�9
For multiple products use product approvalorm r
Desc 'be in detail the type of work to be performed:_ 96 lzg Ce,
Property Owner Inffoormation:
Name: / cl. Address: 13;71 'rte
City A z-,.-e Statq, Zip' Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: l Qualifying Agent:/lU'A�i ?�•�.t
AddressL2/�.S- 1� O City i,T/+C_k 0 A V of t e- Stated Zip
Office Phone Job Site/Contact Number Fax# k9c,, l
State Certification/Registration 00C
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. 1 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 tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six�6)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 herebycertify 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 ofwork will be complied with whetherspeci ted 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.
fe
Signature of Owner Signature of Contractor
Print Name Print Name
.....K. ...........,......... �...............................
Swo o d subscribe b ore me Sworn to and subscri -'
this ay of,JD/ , 20/ 3 this4rnc-Day of "'��"'w% LOIS K.NEL 1i0/3
d6J . : Notary Public-State of Florida
Florida � 1 c My Comm.Expires Oct 30,2016
Notary Public �`� William R Rohn Jr Notary Public ,'•'„F OFr,1op�'� Commission iy EE 847978
My commission EE 193470 /"„1”, evise 1.2 .1
Expires 04126/2016
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Flonda 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. // Q
Legal description of property being improved: K5, ` ;2 T�
Address of property being improved:
General description of improvements: Reroofing
Owner
Address
Owner's interest in site of the improvement Self
Fee Simple Titleholder(if other than owfler) 9�
Jw/ r
Name IV—
Address
Contractor_-4 C_12 )LL N "--)OF/ i�,l b.—EW—
Address 2159 St Johns Sluff Rd Jacksonville,FL 32246
Phone No. 904-619.8790 Fax No. 904-646-1125
Surety(if any)N/A
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 b�e served:
Name AI -0 /�t0 ka_)( /t-t6.-T—NL.
Address 2159 St Johns Bluff Rd Jacksonville, FL 32246
Phone No. 904-619-8790 Fax No.904-646-1125
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. Fili in at Owner's option).
Name � � cS✓�/7��
Address
Phone No _ �� Fax No +/J '
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OW t R A (/
Signed: DATE Wine
Before me this day of'
Doc#2013191480, OR BK 10465 Page 2108, county of Duval, t •e of F r a,has personally appeared
Number Pages. 1 G�'� er in y
Recorded 07/24!2013 at 01:28 PM, imselft hersel and affirms that all statements and declar
are true and accurate DUVAL 4a Notary Public State of Florida
Ronnie Fussell CLERK CIRCUIT COURT ;Q William R Rohn Jr
COUNTY p� My Commiss on EE 193470
RECORDING$10.00 a Fid" Expires 04/2612016
Notary Public at Large. to o County of
My commission expires:
Personally Knov.,n or
Produced identification