275 Beach Ave # 277 2013 roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 13-00003271 Date 8/16/13
Property Address . . . . . . 275 BEACH AVE
Tenant nbr, name . . . . . . # 277
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4900
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Application desc
reroof
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Owner Contractor
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HOLMES MARK H LIVING TRUST DAVID MERRITT CONST. CO. (ROOF)
275 BEACH AVE 108 FLORIDA BLVD
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 993-1697
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4900
Expiration Date . . 2/12/14
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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 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
State of Tax Folio No.
County of
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:
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Address of property being improved: �-77 13-rack 7 �t4Z`-f
General description of improvements:
Owner: -- (GAN C*I Im e S Address: 7 S <j r ,-fl r
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Q Vl�d 444yl CD-Tn C--
ZPJ1 1 Address: � fD�p/�, l F'✓[r1 +2C/
`T Telephone No.: ['7 3'/(D Cf Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone 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:
Telephone 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 Statues. (Fill in at Owner's option)
ame:
Address:
Telephone No: Fax No:
Expiration date of Notic 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 OWNER
r.%
Doc#2013211926,OR BK 16493 Page 1519,
Signed: LDate:� '� -(J----
Number Pages:1 Before me this i7 ay of in the Coun Duval,State
Recorded 08x15,2013 at 09:58 AM, Of Florida..has personally appeared Nuc=✓IC
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of
COUNTY My commission expires: -U4y
RECORDING$10.00 Personally Known:
Produced Identification:
#DD926677
i1= �r,,c;tibar 20,2013
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: (��7 8e0u,4 4L Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. SqYt
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)((circle one):installed?
Residential
If an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes No N/A
Florida Product Approval# r (
For multiple products use pro uct approvalorm
Describe in detail the type of work to be performed:
Vc,g,c�
ProDertv Owner Information:
Name: ar (Mcs Address:
City StateT�Zip a 3 3 Phone
E-Mail or Fax#(Optional)
Contractor Information: I A A ,/
Company Name: U) h1 e-' 4l i�C or? Qualifying Agent: t" e 15SR /V ee y-i&
Address: Z U I City Ubwv 1!l e State P1 C� —Zip 3ZZ _
Office Phone S8'7 SSD Job Site/Contact Number 993-1(o9-2 Fax# Z ZO'37)�
State Certification/Registration# CLC. 13ZSc7 1'7
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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of such)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 hereb certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofYwork 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 rgulating construction or the performance of construction.
14&4L
Signature of Owner ,�,1 Signature of Contractor 1 /
Print Name I ,�!�7 PS PrintL..�Sf.R. /l ..............
S o and subscr' ed before me S orn and su cri a re
th' Day of -- 20 /3 t ' Day o •20
RRITT
Notiiry Public =. •: GAA t'QMMISSIQ�#DD92 Notary u is
7,zptember 20,2013
Revised 01.26.10