1979 Francis Ave 2013 roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
0
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INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003228 Date 8/09/13
Property Address . . . . . . 1979 FRANCIS AVE
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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WILSON, JENNIFER BEACHES HABITAT
1979 FRANCIS AVENUE 1671 FRANCIS AVENUE
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241-1222
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Permit ROOF PERMIT
Additional desc . -
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3500
Expiration Date . . 2/05/14
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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
-3 � 0 U� L� -)
CITY OF ATLANTIC BEACH (I Y'r)
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
AUG 082,13
Job Address: 1979 Francis Ave. Permit Number:
Legal Description:19-016 17-2S-29E 0.202 Dormers R/P of Lot 2 Parcel# y
0 Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 3" Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration �R 0air Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprin=system installed?(Circle one): Yes No N/A
Florida Product Approval# attached
For multiple products use product approval form
Describe in detail the type of work to be performed: Remove and Re-Shingle entire roof w/30yr.Arch. Asphalt
Shingles.Re-nail OSB,new driv edize.cover fascia
Property Owner Information:
Name:Jennifer Wilson Address: 1979 Francis Ave.
City:Atlantic Beach State FL Zip:32233 Phone:(H)#904-241-0918(C)#904-418-1811
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Beaches Habitat Qualifying Agent: Rob Peterson
Address:797 Mayport Rd. —City:Atlantic Beach-State:FL Zip:32233
Office Phone:904-241-1222 Job Site/Contact Number:904-241-1222 Fax#904-241-43 10
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A ca h reb Nana e d he work d n a ns as indica or installation has commenced prior to the
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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 Y6V]i NOTICE OF
COMMENCEMENT.
I here,�j certify that I have read and examined this application and know the same to he true and correct. All provisions of laws and ordinances governing this
) 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 otherfederal,state,or local law regulating construction or the peifiormance of construction.
Signature of 0- _��l�A_
_4ne, Signature of Contractoc _5z�
Print Name Print Name V,�
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Sworn Lo and subscribed before me Swoyt and su befogre
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thi=of , .20 .2013
16APblic N ary u ic
Revised 01.26.10
ed
AWE M.FROMM
JOYCE M.FREEMM
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NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.
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: 19-016 17-2S-29E 0.202 Donners R/P of Lot 2
Address of property being improved:- 1979 Francis Ave.,Atlantic Beach FIL 32233
General description of improvements:New Asp.Shingle Roof, Rem ve and Replace three(3)Exterior doors,
Owner: Jennifer Wilson . Address:1979 Francis Ave.Atlantic Be ch.FIL 32233
Owner's interest in site of the improvement: 100%
Fee Simple Titleholder(if other than owner):
Name:
Contractor:Habitat for Huma ity of the Jacksonville Beaches
Address:797 Mayport Rd,Atlantic Beach,FL 32233
Phone No.: 904-241-1222 Fax No.: 904-241-4310
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(2Xb),Florida Statues. (Fill in at Owner's option)
Name:Habitat for Humanity of the Jacksonville Beaches
Address:797 Mavoort Rd.Atlantic Beach,FL 32233
Phone No.:#904-241-1222 — Fax No.:#904-241-4310
Expiration date of Notice of Commencement(the expiration date is one(1)year form the date of recording unless a different date is
specified):
Warning to owner: Any payments made by the owner after the expiration of the notice of commencement are considered improper
payments under Chapter 713,Part 1,Section 713.13,Florida Statutes,and ran result in your paying twice for improvements to your
property. A notice of commencement must be recorded and posted on the job site before the first inspection. If you intend to obtain
financing,consult with your lender or attorney before commencing work or recording your notice of commencement.
THIS SPACE FOR RECORDER'S USE OWNER
Signed Date: 6 — Z — 13
for,
Be th�isday fA11 A dA in the County of Duval,
is
or Ily -i4d
State o,klorida,has personally ap6e
Notary Public att—a—rg—e—,St—ate of Florida,County of Duval
My commission expires:
Personally Known: 6-11 or
Doc#2013206753,OR BK 16486 Page 2016, Produced Identification:
Number Pages. I
Recorded 08.;09/2013 at 0&29 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10 00
AM IA.01181101
"OtKy P*k-rAft 0 two
My CWA.ENWO JIM 1$-07
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