800 Seminole Rd 2014 Chambers roof CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
14-00000207 Date 2/12/14
Application Number g00 SEMINOLE RD
Property Address . . . . .
Tenant nbr, name . . . . . . COMMISSION CHAMBERS
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 8700
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Application desc
reroof
------------------------------
Owner Contractor
_ _ ------------------------
---------------
CITY OF ATLANTIC BEACH SHORE ROOFING COMPANY
914 7TH AVENUE SOUTH
800 SEMINOLE RD
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 241-8842
-----------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . • Plan Check Fee . 00
Permit Fee . . . . 95 . 00 8700
Issue Date Valuation
Expiration Date . . 8/11/14
--------------------------
-------------
----------- 2 . 00
Other Fees STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE
Fee summary Charged
---
Paid Credited ----Due---
------------ ----------
. 00----
95 . 00 . 00
Permit Fee Total 95 . 00 00 00 . 00
Plan Check Total • 00 00 . 00 4 . . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 99 . 00 99 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of r-1 County of F, H-
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. / t ^�
Le al description of property being improved: 0 �CG /—
SI03T U Na
rc el- 01 /
Address
��ofproperty being improved: .SCA? ® �� 14fi-1�I CrS
) c,
_ 34••��1J S
General description of improvements: Rt I wt,F
Owner N� C ?t,
ScAddress OLSM/'V.� � cG t e- �` � .3 3,
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor c>r(, / UO r•'
Address �4�i wi4� �yftivC ►'rF C�.(i "'! ,?2Z�0
Phone No. ��'�g�lL Fax No. 2 IJ t
Surety(if any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a ban for the construction of the improvements.
Name
Address
Phone No. Fax Na
Doc#2014032411,OR BK 16681 Page 2202,
Name of person within the State of Florida,other than himself,c Number Pages:1
documents may be served: RecordeRonnie Fuusssel C2LOERKtCIR11 CU CIRCUIT DUVAL
Name COUNTY
Address RECORDING$10.00
Phone No. Fax
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 front the date of recording unless a
different date is specified):
�
THIS SPACE FOR RECORDER'S USE ONLY ^`- 4
Signe N —WATE
Before me this y of in the
Coun of al, tate Flo' ,h ally peared
herein by
h mself!herself and a imrs tha II stat ant an declarations herein
are true and accurate
r
4tory blic at Large, a of County of
mission expires:
u
Personally Known or
Produced Identification
JENNIFER WALKER
:? My COMMISSION It FF 011480
=•; `= 2017
-�:•. _ EXPIRES.ppriIF24,��w�Pn
f BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road;Atlantic Beach, FL 32233 FEB 11 14
Office (904)247-5826 Fax(904)247-5845
�r1PP
+M� S1 BY
Job Address: Sob S t/YYII� '�`'C tt'1'L�Wermit Num er:
Legal Description Parcel#
Floor Area o q. t. Sq.Ft
Valuation of Work$0-1006 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 Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#FU 1
For multiple products use product approval form
Describe in detail the type of work to be performed: 1 �
CL^O�,ml�i✓S
ProveProvertv Owner Information: �_
LA—
Nam*orFax
� l�17111,(. dreams: DIDS(j I fr iO
City to ip �3Phone
E-M #(Optional)
Contractor Information: `�
Company Name: ,5 AU✓(, /�y D rl'-,i Co Qualifying A ent: yl1ltf �✓�' Z a
Address: .3 'r W t- City `— State —r zip 3Z 3
Office Phone 2- Job Site/Contact Number # yf —
State Certification/Registration
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 or
n is hereby made to obtain a pesixrmit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
hi
issuance of a permit and that alt work will be performemontd to meet the standards of all laws rpegulating construction in thpis jurisdiction. Tlzis permit becomes mill
work iis�
........
n enced.ot I understand thatrseparate per s m st be secured for ECectricual Workd Plumbtng,Signs,aWells�Pools,X urnaces, Boile s trKeatersr
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.
1 hereby 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 whether specified 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 reRlating construction or the performance of construction.
Signature of Owner � TG Signature of Contractor �l
Print Name
Vit"( Print Name ji'►llF.f ..............................
.. . ........................................................
Swo and subscribed before me Sworrytp d subsc,�l d before me 20 LA
this ay of 20 this ay of )"f'Y�
r
No ary lie of Pu lie
V JENNIFER WAR
JENNIFER WALKER �'�' :
•;;�+ ,, �`' MY COMMISSION 4 FF 0&4J4i s 01.26.10
_*. x MY COMMISSION M FF 011480 =*: = EXPIRES:April 24 2017
�• :a EXPIRES:April 24,2017 =? Boaded1twu PuMicUndeMiders
Rf,t4 Bontled TNu Notary Puck Underwrden