438 Inland Way Roof 2013 CITY OF ATLANTIC BEAD,
J 800 SEMINOLE ROAD
J
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
0A
Application Number . . . . . 13-00003436 Date 9/23/13
Property Address . . . . . . 438 INLAND WAY
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 13400
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Application desc
roof
-- -------------------------------------------------------------------------
Owner Contractor
-----------------
------------------------
COLEMAN DONALD R JR CENTURY CONSTRUCTION INC
438 INLAND WAY 509 PORPOISE POINT DR
ATLANTIC BEACH FL 322334682 NE
(904UG669I8411 FL 32084
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Permit . . . . . . ROOF PERMIT
Additional desc . . 00
Permit Fee 120 . 00 Plan Check Fee 13400
Issue Date . . . Valuation
Expiration Date 3/22/14
Other Fees
STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
____ _ ________ --
Fee summary Charged
Paid Credited ----Due---
_ _ _ ----------
----- ---------- -
Permit Fee Total 120 . 00 120 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 124 . 00 124 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
�
BUILDING r`PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole:Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Permit Number:
Job Address: 7l) ► t U� t�
S'2� 0��"�q
I hi+Parcel# 9��3 � ,5�
Legal Description oh
ea o t
non-heated/cooled
Valuation of Work$ Proposed Work heated/cooled
Class of Work(circle one): New Addition Alteration Repa Move Demolition pool/spa window/door
circle one)- Commercial Residential o N/A
Use of existing/pro osed structures)( Y ) '► Circle one
If an existing structure,is a fj1prinkler s steminstalled. ( )Florida Product Approval# rct rova form
For multiple products use p app
Describe in detail the type of work to be performed: �U
Property Owner Information:
Address: .3 n d
Name ' 101`r'1
City.
Stat Zip 3 Phone
E-Mail or Fax#(Optional)
Contractor Information:
U QuaPingent: State Zip
Company Name: City
Address: S Fax#
Office Phoneob Site/Contact Number ' 1
State Certification/Registration# C I SLI U$
Architect Nance&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder ddress
Bonding Company Name and Address
Mortgage Lender Name and Address
months at any time wers
has
to the
e ormed to meet the standards of all laws regulatingoconstruction for t is juri do s�on6)�is permit becomes null
A lication is hereby made to obtain a permit to do the work and installations as indicated ertify that no work or installation n. commenced prior s
is uance of a permit and that all work will b P months, or if construction or work is sus a S`i ns, lls�pools, Furnaces,Boilers,Heaters,
and void of work is not commenced within sex(6)
S
works and Air commenced.
iounde,retGnd that separate permits must be secured for Electric Work,P1un�bing,
Tan WARNING TO OWNER: YOUR FAILURE ' RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TINANCING, CON S LT WITH
IC
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN F
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
YOUR COMMENCEMEN
eve authority to violate or cancel the
certify that 1 have read and examined this plication and know the same to be true and correct. t p provisions of laws and ordinances governing this
1 hereb fY
aw re 1 nstruction or the performance of construction.
type owork well be complied with whether sPeci eed herein or not. The granting of a permit does not presume t4`g
provisions of any other federal,state,or local 1 gu
Signature of Owner Signature of Con tr ctor
Print Name l�C?.�. .. .�?.tn .._ .G..................................... _........
Print Name_.,: _ .......... . ....... _..._........
Sworn to and subsc ed efore me 2 3 Sworn aD� o
ndsusibed�before m 20 3
this�Day of this
tary Public tary Pu is
ERIN PM ERIN PRTS Revi ed 01.26.10
Y W COMMISSION#EEEB84li99 uR� W COMMISSION#FEE88*99
EXPIRES:MAR 17,2017 DIP M:MAR 17,2017
Bonded tM O 1st Stale b�surance Bonded ttua�ph tat State I�urenCl
NOTICE OF COMMENCEMENT
(PREPARE H DUPLICATE)
Permit No Tax Folio No
State of 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 imp r v —0 01
Address of property bein i proved: /3 ( 2
V `
General description of improvements: /
Owner �
Address
C !
Owner's interest in site of the improvement
Fee Simple Titleholder(it other than owner)
Name
/ Address
Contractor r
Address
Phone N
Fax No.
No.
Surety(if any)
Amount of bond$
Address
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 Nd.
In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone 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):
N
THIS SPACE FOR RECORDER'S USE ONLY
Sgt- ' ) DIS n 1
d4w�111,ra�
Befor
day of�
ry
Of Dyv@I. j;3 d Fla.Fjas Ian IIared herein by
Doc#2013244451,OR BK 16536 Page 181, R herein
t[f
Number Pages:1 t ie herself and end accurate alit that all statnrrrcntsand declarations
are true B.G.KING
Recorded 09/23/2013 at 08:49 AM, are
Notary Public,State of Florida
Ronnie Fussell CLERK CIRCUIT COURT DUVAL My Comm,Expires November 15,2011,
COUNTY
RECORDING$10.00 --Commission No.EE 136140
Nntary Putdir'M 1 area Stall of OQr A ,n of�K��
i