850 14th Street West ROOF 2013 CITY OF ATLANTIC BEACH
iIZ
800 SEMINOLE ROAD
J ;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�Ji3l�
Application Number . . . . . 13-00003380 Date 9/09/13
Property Address . . . . . . 850 W 14TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
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Application desc
reroof
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Owner Contractor
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LYON, JONATHAN R REMODELING ETC, INC.
1837 SEA OATS DR 1210 MAYER ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 898-2700
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Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 80 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 3/08/14
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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 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 CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
1 40TICE OF COMMEN";:�c�l 2E.'
State of _-- -___—____.._..— — -
County of
To Whom It M'.av Con er :
The undersianed .riere*nv finforms you that improvements will be made to certain-ea',' prone ,. and in accordan—ct with Section 713 of
the Florida Statutes, he follov,ina information is stated in this NOTICE OF ClviMENS '_M l�T.
Legal Description o property being improved:
Address of propern'oeinR improved: 1�5 P I q S 7— L�1��G
General description:of improvements:
Owmer: J O h� �'<h � ��'[� ^•- Address: 93 7
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner): - ---
Name:
/GSC C
t C tractor:
Address: ��� (/ Cf 31 � I
Telephone No.: 3 f '7��� Fax No:
Surety(if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: Al
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: /V f
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. (Fol mat QwnerIs option)
Name: / /
Address:
Telephone No: Fax No:
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 OWNER
Signed: Date: J
Before me this day of (/LG G» f in the County of Duv 1,State
Doc#2013232099 OR BK 16520 Page 1294, Of Florida,has personally appeared '794
Number Pages:t Notary Public at Large,State of Florida,County of Duval.
Recorded 09 09'2013 at 1 RC IT My commission expires:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL personally Known: ' or
COUNTY
RECORDING$10.00 Produced Identification:
Came.NO.IN)95gOff4
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: $50 dEnL / L/ d k ST,Q Ec T 134-G. Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of WorkaD+'` Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):. Commercial esidentia
If an existing structure,is a fire sprinkler system installed? (Circle one): o N/A
Florida Product Approval# ZEK= / Q/1�-y/ /
For multiple products use product approval oriorm
Describe in detail the type of work to be performed:
Property Owner Information:
-- ^
Name: J P nk (2• �yo Address: 18.37
City TL T?c. Statep ��2 3 Phone D y
E-Mail or Fax#(Optional) 4-YON
Contractor Information: ,
f
Company Name: ✓/1 Oualifyin Agent: LSSPi mi
Address: D a City State - Zip
Office Phone
'9 57 Job Site/Contact Number Fax# '9 V3-
State Certification/Registration# l C/0 L 77 Zy
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and
Address-
Bonding
ddressBonding 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 Pix(6)
months at any time after work is commenced. I understand thhat separate permits must be secured for Electrical Work,Plumbing,Signs, Wei s,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 provisions of laws and ordinances
governtn this type of 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 other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner X40-2-- Signature of Contractor
Print Name 1I Ai{Ah� L 0 r Print Name . S..! �- s........................
..................................... .✓
..................................................... ............................. .......................................
and
Swor1}pq and subscribrcle� 6 Dayof subscribed
sc Sc b/ e 20
//��""4 4 20 thus
this // D
Notary Public Inin
tate o/Fl a
t eves 01.26.10
Ronald S.C'ohcn EE 862797
017
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Notary public.State of Florida
1 My Comm.Expires May 30.2014
Comm.No.W 984W4