393 Atlantic Blvd 2-14 roof 2013 CITY_ OF ATLANTIC BEACII�
Is1
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J _
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003723 Date 11/21/13
Property Address . . . . . . 363 ATLANTIC BLVD
Tenant nbr, name . . . . . . UNIT 2-14
Application type description ROOF PERMIT
Property Zoning . . . . . . . CENTRAL BUSINESS DISTRICT
Application valuation . . . . 47000
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Application desc
reroof
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Owner Contractor
------------------------ ------------------------
SHOPPES OF NORSHORE LLC EXCEL ROOFING CONTRACTING
P.O. BOX 330108 5722 DUNN AVE
ATLANTIC BEACH FL 32233 MIDDLEBURG FL 32068
(904) 463-3438
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 285 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 47000
Expiration Date . . 5/20/14
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Other Fees . . . . . . . STATE DCA SURCHARGE 4 . 28
STATE DBPR SURCHARGE 4 . 28
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Fee summary Charged PaidCredited Due
--- - ----
---
Permit Fee Total 285 . 00 285 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 8 . 56 8 . 56 . 00 . 00
Grand Total 293 . 56 293 . 56 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
State ofTax 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: -t<4 ^L1 IS ~2-CL V— kk\o nkA C-1 0-01yv
�u \i VlS"ZX\ 3 ilc0\ M\dn-Y,(. 'f3.CY1
Address of property being improved: 31v Monk'.
General description of improvements: yeyU Wit_ lka
Owner: 1Y poo \3 mnhbre.LLL Address: R 0,bc7c 5aQo 9j Wan'6C 6go-da 612-6 6
Owner's interest in site of the improvement:
=-E� SUvt
Fee Simple Titleholder(if other than owner):
Name:
Contractor: w, -t
^� Address:
Telephone No.: Q-0 11 D3 �iR1C:'S Fax No: �q 1 2.1►�-L7JL 1
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(2xb),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
z Wil;?
Signed: ' - �te. lit I-%
1 J
Before me this 14�rN fin the County of Duval,State
BETHANY L SALCAN Of Florida has personally appeared
�►" °e'•., Notary Public at Large,State of Florida.County of Duval.
,?? Notary Public-State of Florida _.
.• .: My commission exprsonires; °y :� =+ r
My Comm.Erpires Apt 17,2015 Personally Kwru
Commission#EE 85067 _ _ Y ._noa
•-';,��..;��'- Produced-tdentification:
Bonded Through National Notary Assn.
Doc#2013298409.OR BK 16604 Page 2240,
Number Pages: 1
Recorded 11 121'2013 at 11 42 AM,
Ronnie Fussell CLERK CIR C'.iIT COURT DUVAL
COUNTY
RECORDING$10.00
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 363 WaMAC bkvd. CoQ4P_S 'L-ly Permit Number:
Legal Description t�-loo► 1.11- 7 S-Z-9E I.tvS 0tk rW% C Rje-UCh Parcel# 10-150'0000
oor rea o q. t. Sq.Ft
Valuation of Work$�►�]�000.00 Proposed Work heated/cooled non-heated/cooled�6tC`O
k F
Class of Work(circle one): N Addition Iteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system install'e�&-fGircleAdne): Yes No N/A
Florida Product Approval# r L 91 5 L I �tS�
For multiple products use product approval form
Describe in detail the type of work to be performed: RGQ1OOG 14 [YI lv4d= YYl N n 6k/l yj
Proaerty Owner Information:
Name: Sv)nornS Ck k�zx hotc_LU_ Address: 1P.Q.30) MOO OI 3 ik i kkh�i r_i3w a& V-L
rF1
City � cg\� ,c 1riP C i c .>n StateF-k-Zip, Phone 4CXt 2L-I I-1 ibI
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:EycQ.\ Fi m Qualifying Agent: Tl-�A&n s h
Address: S l'LZ T1_y%n to%z- City State SL_`Zip 322.1`6
Office Phone 904 to 3 l- rl to la3 Job Site/Contact Number t-((03- 3 L(3 _Fax _oac l
State Certification/Registration# ('o L (.S �\!d- q O(a
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 six(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, urnaces,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]have read and examined thisplication and know the same to be true and correct. All provisions of I s a dor finances governing this
type o work will be complied with whether spec:i d rein or not. The granting of a permit does not presume to gyve art rit to violate or cancel the
provisions of any other federal,stat , r local law r sting construct: he performance of construction.
Signature of Owner Signature of Contractor
Print Name NA l ....ri.lffij - ..._._ Print Name j�_D ,�2 E tls Evl
Sworn to and subscribed before me Sworn t (and subscribed before me
Aisq Day of 201 th' -Day of (�Qd ewe er .20 l3
(Ca"C�r
Notary Public Notary Public
Revised 01.26.10
Jti r.a,, BETHANY L SALCAN
Notary Public-State of Florida
"���., BETHANY L SALCAN
•=My Comm.Expires Apr 17,2015 ip`'�v' ,,y, Notary Public-State of Florida
�`�,- Commission�EE 850ti7 •;�r Comm.Expires Apr 17,2015
' "` Bonded Through National Notary Assn. =�, d= Commission•EE 65067
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Bonded Through National Notary Asan..