386 6th St 2013 roof CITY OF ATLANTIC BEAM
Is) 800 SEMINOLE ROAD
�r ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003740 Date 11/25/13
Property Address . . . . . . 386 6TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation 12000
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Application desc
reroof
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-- -------------------------------------------------------------------
Owner Contractor
_ --------------
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WILLIAMS MICHAEL P & MICHELE POJUSTIN
LAR CONSTRUCTION INC
386 6TH ST
ATLANTIC BEACH FL 322335348 4784 CATTAIL ST FL 32068
MIDDLEBURG
(904) 241-0320
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Permit . . . . . . ROOF PERMIT
Additional desc . . 00
Permit Fee . . . . 110 . 00 Plan Check Fee • • 12000
Issue Date Valuation
Expiration Date 5/24/14
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-------------------- 2 . 00
Other Fees STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
__ _ ________ ----
Fee summary Charged
Paid Credited ----Due---
. 00
_ _ ----------
----- ----------
- . 00
Permit Fee Total 110 . 00 110 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00
Grand Total
114 . 00 114 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Doc#2013301765,OR BK 16608 Page 1824,
NOIRT 0F C'0MN1ENCEMEN1' Number Pages:l
Recorded 11/25!2013 at 10:1 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Permit No. _. _ _-_ _ __.._. RECORDING$10.00
Tax Folio Nei.
TI IF tlNl)I•:KSI(',N1-',1) hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713 11 of the Florida Statutes,the following information its provided inthisNOTI('E OP'('OMml,"WEM/E.N. T.
l.Description of property (legal dPu•ripliun): S_lp_1_ p{s-a'q \L ttc:'C4
a)Street(joh) Address: 3E Glb �� �� >2233
2.General description of improvements: � I
3.Owner Information `
a)Name and address:
b)Name and address of fee simple titleh( er(if other than owner)
c) Interest in property
4.Contractor Information ,,''// 11(r__�n
a)Name and address: l,Q� vl �>�- L/'"?O W4,kq.:
b)Telephone No.: �Qt� _ ,? -1f31 + _.._ - Fax No. (Opt.) �D�{-_��f>�'.e
5.Surety Information
a)Name and address:
b)Amount of Bond:
c)'I'elephone No.: Fax No.(Opt.)
6.1,ender
a)Name and address:
Phone No.
7. Identity of person within the State of Florida designated by owner u on whom notices or other documents may be served:
a)Name and address:
b)Telephone No.: _ __ Fax No.(Opt.)
8.In addition ti-himself,owner designates the follow perso to receive a copy of the Lienor's Notice as provided in Section
713.13(I)(b),Florida Statutes:
a)Name and address:
b)Telephone No.:--------- - --- — - Fax No.(Opt.). - - - -
9.Expiration date of Notice o 6C ltn encemcnt(the expir fon is one year from the date of recording unless s different date
is speciTied):
WARNING TO OWNER: ANY PAYMFNTS MADE BV THE OWNER AFTER TIIIE 1sX1'IRAT1ON OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,
FLORIDA STA'1 UTFS,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROWMI,NTS TO YOUR PROPERTY.
A NOTI('F,OF('OMMF.N(r'FMFN?'Mi IST RF.RFCORDFD AND POSTED ON T111F.3011tiJTV Nk:FORK'1'11F FIRST
INSI'VA." 'ION. IFY0111 INT END T'O OBTAIN FINANCING,CONSULT YOUR LENDER OR AN A'1-FORNEY BEFORF
COMME.WiN(: WORK Olt R1,('OR1)1N(. YOUR NOTI('M;OF(:OMMF. 4; F
SIA11.01 VIAMIIIA '
cotwivoe b"$A L 10. Av''
Signalure of Uwllol of wou'',i�Authotii� rO,Il�iwr,/Djilw.I,nlParUlur/Man ges
(y�hiinjntt Nanx ��` // �/ s '1NT.,�Q �Iy—�rte✓ �4{/�` q �L j
I•he foregoing_ instrument was acknowledged bclixe me(his 20t tly of /VD Y -"4oL/`a0 �3 ,by If e' kv,
Lt���+< /[rl►� as e1>A-1A)6)t (iyl/e of nulhurily,c.p. orficer,ii-twee,
81(01-11e) ill foci) for 986 Ul 4. (2z- (pante of Polly oilqAwlwi
ni- 4
Personally Known Olt I'roduced Ide•nliftcalion V/ Notary Sihnalure
IypcofIdentification Produced W452-5-5070%�O Name(print) '�����
OR
Verific;llion pursuant to lwoion 9", S 5. 1 lolida Stalutc.s. !Undoes pcnallics of perjury, I dck-l'sl ;11 1 Ilmi. Icad III( folgfpini- and Ihat
the facts slated ill it rite Iluc to III( I'csl of 111) knowlc•df-r and Relief.
IIID�1�•.IN ->I:'rr ,,11111/,I
♦11�V PV���-' MARIA PIMIENTA \r,nv�urr ol'tirlru;ll I'rl�nr':r•rrr.lr Ian nnr R III 1.�I�.,,
='r�• °S. Notary Public-State of Florida
�=My Comm.Expires Jan 26,2015
�'; � Commission I EE 59080
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
CL0,eV,,al
Address: 56� 1A-, S- � Permit Number:
Description �- 1o� a rte Parcel #
FIoor rea o —Sq. t. q.F t
Valuation of Work $ �2 K Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration epair Move Demolition pooVspa window/door
Use of existing/proposed structure(s) circle one): Commercial esldentia
If an existing structure, is a fire sprinkler system installed? (Circle o N /A
Florida Product Approval # Ftl XX
For multiple products use product approval form
Describe in detail the type of work to be performed: , h PrCV- Au--4ax 0 Z'y'l-O.'es
Property Owner Information:
Name: &fi S Address:
City State ELZip Phone —450— O
E-Mail or Fax # (Optiopal)
Contractor Information: n
Company Name: Quali ing eat: �T
Address: City , State rZ Zip 32�
Office Phone — 2 —D Job Site/Contact Number D — — Fax# —a
State Certification/Registration # CCC I a2-68*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 indicated. I 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 consiruetion or work is susp ended or abandoned for a period ojshx(6)months at any rime n%ter
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, 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 herebv certify 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 of work will be complied with hether specified herein or not. The granting of a permit does not presume to give uthori violate or cancel the
provisions of anv other f7AW-
ulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print NameT/.................l-t
0 1
1✓l/.G ti -.........lrJl...�-.L....�4�'V1.S...................
Sworn t an su cribed or me Sworn tg an su ribed or me
this 1 this 2i L
Y'r( CV ARIA PIMIENTA ARIA PIMIENTA
lic.Stilt
i:ftIffiC-state of FloridaNotary P bl►c P; My Comm. Expires Jan 26,2015
Not I ? My Comm.Expires Jan 26,2015 �,�cF.-
Commission!EE 59080
n�A;` 'gyp,n,,.
Commission�EE 59080