543 Pelican Key 2013 ROOF CITY OF ATLANTIC BEAGI
j 800 SEMINOLE ROAD
:) = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 13-00003482 Date 10/01/13
Property Address . . . . . . 543 PELICAN KEY
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6990
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Application desc
reroof
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Owner Contractor
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URBAN, STEPHEN JACK C. WILSON ROOFING CO.
543 PELICAN KEY 4522 ST. AUGUSTINE RD.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 396-1546
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6990
Expiration Date . . 3/30/14
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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 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 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: 3 P"Ca ffQq Permit Number:
Legal Description 43-I I 1 ') - a5- OTR E -SA- Ja Gr,-,V 'A, Parcel# 55d_'c�k
oole o Sq. t. 't
Valuation of Work S ���� •�� Proposed Work heated/cooled ! 3 Dc non-heated/cooled
Class of Work(circle one):(\ New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposedstructure(s)(circle one): Commercial esi
If an existing strucure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval# jway
For multiple products use product approval orm
Describe in detail the type of work to be performed: Atin 6W ond rc r^oolzp EX(5 .rj o
, red -3 chi O
Property Owner Information: ,r
Name:�r �{U `J
� CS IJ Address:c57 3
Citycmcc.6, State I Zip ?233 Phone o
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:� �� Qualifying Agent: c lJ
Ess
Address: 5aa City��jc , State Zip 3,Q&2
Office Phone 0Y- `36- Job Site/Contact Number OSI- q.:22-A5 Q5 Fax# 9-UV--- 39(.-- 71.6
State Certification/Registration#_CC- C 6q9,3_52
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 I cert 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 ofsix[6)months at any time after
work is commenced, I understand that separate permits must be secured jor Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Healers,
Tanks and Air Conditioners,etG
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.
1 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
work will be complied with whether speci ied 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 lire regulating construction or the performance of construction.
1 _ n
Signature of Owner T 9- Signature of Contractor
Print Name T� lf�ivS.�v�J Print Name
................f.........................................................................._............._.... I`............................Y.........................................._..................................................
Sworn to and subscribed be ore meSworn to and subscribed before me
this Day of .201 .3 this 2 . Day of 20/Z
74�c
Notary Public HER v0SS Notary Pubh ER v0
a DD 944280 DD g
CHRISTOPHER CHRISTOP 44280
_® _ Commission mission Expires 1-1 Comm COmmissio gFs�clQl. 10
My con-,nbeMy Comm 201
cember 03, 2013 as ember 03,
, FOF F�`.`` De i,'yf OPS Dec-1
NOTICE OF COMMENCEMENT ry
State of CJ N'% O Tax Folio No
Countyof
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: �� J I a S _ ��115S e 1 V61- Laik&-5 IJ n t 7 1
A
Address of property being improved: 4ne../I C o-Nf Lai) n C1 &Qc l W. �"Z 33
General descriptio of improvements Ar'D a Q n d f } S-t f aI r`6 C CA '-7-
-
General
6 e C-Pd
Owner: ll /� bQ Address,- 6!V ��� C�rl k- ,UCA3�
Owner's interest in site of the improvement: n Lt)1(re rc.
ee Simple Titleholder(if other than owner):
Name:
Contra or: r
T C./2 Sd rJ
�a
Address: as ,50, n+ G
Telephone No.: O — 9 /,5YLJ Fax No:90 y-39 6— '7700
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Doc#2013252092,OR BK 16546 Page 1025,
Name and address of any person making a loan for the construction of the improve Number Pages: 1
Recorded 10/01/2013 at 12:34 PM,
Name: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING$10.00
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)
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:
Before me this day of t` in the County of Duval,State
SS
C IS1 OQ pR 9 Ota OOfFlorida,
t to i bl ahas pe personally appeared County
I "olm"Pue` VA 155.0 DEXp.jtes State of Florida, of Duval.
} „= CMV Comm;ssl p3 2013 My commission expires:
' ber Personally Known: or
pece
tn
Produced Identification: