615 Amberjack Ln 2013 roof CITY OF ATLANTIC BEACH
f s� 800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003829 Date 12/12/13
Property Address . . . . . . 615 AMBERJACK LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5000
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Application desc
fl 10674
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Owner Contractor
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DENNIS, JAMES R SOUTHERN COAST ROOFING & CONS
4641 WHITES POINT 4557 EAST SENEGA DR
GENEVA NY 14456 904 333-5915
JACKSONVILLE FL 32259
(904) 305-8887
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Permit ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 75 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 5000
Expiration Date . . 6/10/14
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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 75 . 00 75 . 00 . 00
. 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATIONI L
CITY OF ATLANTIC BEACH 22 0013
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 [DECBy
Job Address: _(�� Ipz��p (- Permit Number:
11
Legal Description 3 0-(60 - 14 -2 S - 2 w 9 E Row �a,/w� ��J Parcel#
F oor ea o q. t. q'_'t
Valuation of Work$Som,op Proposed Work heated/cooled Zq non-heated/cooled (021
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial �esmo
If an existing structure,is a fire sprinkler system installed? (Circle one): N/A
Florida Product Approval# FL
For multiple products use product approval form
Describe in detail the type of work to be performed: Roo�1n.P
Propertv Owner Information:
Name: Q 5 Address: 9 b4/ t thHeg kjg�
City &GnQ41 State wzip_hone
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: j���d fa� _� Qualifying Agent: I&
_b
Address: USS3 �• eCM�r. v ' City_Sc".f ?h 14 C-$ State _Zip 3'L2 s�{
Office Phone Job Site/Contact Number 9au gg } Fax#
State Certificatio egistration# LC.L 13 L Fri 6
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 construction or work is suspended or abandoned for a period of six 6)months at any time after
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 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether speci,ed 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.
J>Zo 11'2_1X1162 �- oC �
Signature of Owner J/1Vrti� Signature of Contractor
Print Name ..dAR4.�.........n .hhl.s.................................... Print Name
.................................................................
Bef Before
this Day of 2013 t ay f 20
/2-3O
No 'AY
tic; IFER WALKER o: EYP a ruary 14, 17,
;° ,. MY COMMISSION 11 FF 0114aC) '?„pf�tfi�' Bonded Thru Nnt-y Public Underwriters
�•. .'o EXPIRES;April 24,2017 Revised 01.26.10
^?of Via?. Bonded Thru Notary PuWk Und/iwrker6
F
NOTIC�OF COMMENCEMENT
t
State of ��ami - _-- 1 ax Folio No.
County ofTo Whom It May Concern:
The undersigned hereby informs ou that improve will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is in this NOTICE OF COMMENCEMENT-
Legal Description of property being improved.
Address ofproperty being improved: r ,_' ►3�� rTT�ch lig- �Et ( �c���`
General description of improvements: /ru)
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Owner:_..- r t HQv�- . t 1 a1 r S 1 Address: / l7�YlE�P_ ! 4�_._ ,,/Z
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner): -
Name:
�4 Contractor:4, ;-:f', ✓.�- L✓' ,.•- f
Address: l � a � _�/'' -
Telephone N..:,7 C �'� Far No
Surety(if any)
Address: Amount of Bond S
Telephone No: _ Fax No:
Name and address of any person making a loan for the bris6viction of tate improvements
Y:
Name:
Address: --- - —--- --
Phone Na Fa\No:
Name of person within the State +Florida,other than himself,designated by owner upon whom notices o. other documents may be
served: Name:
Telephone No:- Fax No:
In addition to himself, owner designates the tollowirk
person to receive a copy of the Lienor's Notice as provided in Section
i 3,06(2)(b),Florida Statues. Vil)in at Owner's
Name: = , ?I - --
Address: -
Telephone No: _ Fax No: -
Expiration date of Notice of Commencement(the expi4tioti date is one(1)year from the date of recording unless a different date is
specified):_--- ---_ 1 -_.. - _ __ ----._..._._._._.- —..—._-
TRIS SPACE FOR RECORDF.F':S USE ONLY 01�VIVE> r 1� /a,- S
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dumber aag� t 30 PM. Public at Largo State of Flu0- County of[k�val
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Ronnie Fussea CLERK ly Known: --_- �
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