1834 George St 2013 roof J
CITY OF ATLANTIC BEACH
S 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
�r
Application Number . . . . . 13-00003577 Date 10/25/13
Property Address . . . . . . 1834 GEORGE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7800
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Application desc
reroof
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Owner Contractor
------------------------
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TRIUMPH APOSTOLIC FAITH CHURCH GREAT WHITE CONSTRUCTION INC
1834 GEORGE ST 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 322331914 JACKSONVILLE FL 32216
(904) 838-1659
-----Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 90 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 7800
Expiration Date . . 4/23/14
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Other Fees STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
----- ---------- -
Permit Fee Total 90 . 00 90 . 00
. 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 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: 193LA CSe(�r(4f Si- kf�rk lb BCV)t Fl— Permit Number:
Legal Description Don n--_r�IJ V_I E ";�, L o i 31 y , s E l k I Parcel#
'Floor Area of q. t. 'q. t
Valuation of Work$ 1800, 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): Commercial Residentia
If an existing structure,is a fire sprinkler system installed? (Circle one): es o N/A
Florida Product Approval # 11J(3y, l 10
For multiple products use product approval form
Describe in detail the type of work to be performed: Mf 00[ 4-7 sq
Property
S I a-
Property Owner Information:
Name: Yll l S+ i C �G_if*l ft0k-ddress: IS34 rn rut Sfi
City State r:L_Zi 3 p-a 3 Phone q d it-7 " 6 y 73
E-Mail or Fax#(Optional) J O S m 1-19'1 '13 �°1(S 6utU►, y��+-
Contractor Information:
Company 4;,616
rae: �J(2U �Vh Irk COhb�Yl�G�7d h Qualifying Agent: I 1 a Y I S h if-
Address: City �-z State_ L Zip 311 b
Office Phone 9 fr3J- Job Site Contact NumberTr 3 -(bs°l Fax# -8(0(0-"11/
State Certification/Registration# W(! 12,19611-7
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 indis icated. !certify that no work or installation has commenced prior et
o the
issuance of a permit and that all work will be performed to meet the standards of all laws rpegulating construction in thpis jurisdiction. This permit becomes null
work isd mmenced.ot 1 understand that separate permits mu t be secured for Electrical Workl Plumbing, Signs,aWellsoPoolsxl�urnacessBoilerystHeatersY
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 BEOR ENTE RECORDING YOUR NOTICE OF
COMME1 here b 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 of 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 law regulating construction or the performance of construction.
Signature of Owner L/ — Signature of Contractor 'i
Print Name Jan.n......Sm%..�h............................................................................. Print Name ..1.!kv—..�.5.......��. ..h_fiL.V...............................................
Q... . .
Sworn to and subscribed before me Sworn to and subscribed before me 20
this of I Day of r 20 t3 this at-Day of
,,� �1Y P•����' " ASHLEY RIDGEWAY
ASHLEY RIDGEWAY
? Notary Public-State 8f1t3cwV ublic * N ry Public-State of Florida
Notary Publ'c .•= ' My omm.Expires Jun 20,2017
=N ,;My Comm.Expires Jun 20,2017
=a,F �P•' •-,',F,o; ised:fhlmi 6&d& FF 29966
Commission#FF 29966
a 0 l 3a'l�-"13'1 OR C3ooK Pips- al- Pie -1 aO Nur\ oA
at 02 :28 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
To whom it may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: DOnrlerS RIP Z Lot 3, 4, 5 Blk 1
Address of properly being improved: 1834 George St Atlantic Beach, FL 32233
General description of improvements: reroof
owner Triumph Apostolic Faith Church
Address 1 834 George St Atlantic Beach, FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Great White Construction
Address 4320 Deerwood Lake Parkway Jax,FL 32216
Phone No. 904-838-1659 Fax No. 1-866-746-1840
Surety(if any)
Address Amount of bond$
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.
M 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 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):
TN1S SPACE FOR RECORDER'S USE ONLY— OWNER
S goad: DATE I 0-2 t-13
Beforin Me
e is 21 day of �LtDhrr
Coun
Du Stat Stats of Florida,has personaRY appeared
�Cih 105 m i-61 herein by
himself(herself and amrms that all statements and declarations herein
are true and accurate
��t+��ua'•.,• ASHLEY RICGEWAY
Notary Public-State of Florida
My Comm.EzpireS Jun 20,2017
Notary Public a go,stat f C 1. fission# FF 29966
My corn iss e r ••r1p1
PersonallyKno n _ ---- —
Produced drantfication __