392 7th St roof 2014 CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
j � ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000310 Date 3/06/14
Property Address . . . . . . 392 7TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 7500
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Application desc
reroof
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Owner Contractor
-
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HARVEY SHORTELL TRUST A CROWN ROOFING INC
392 7TH STREET 2159 ST JOHN' S BLUFF RD S
ATLANTIC BEACH FL 322335434 JACKSONVILLE FL 32246
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Permit . . . . . . ROOF PERMIT
Additional desc .
Permit Fee 90 . 00 Plan Check Fee . 00
Issue Date . . . Valuation 7500
Expiration Date . . 9/02/14
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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 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.
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.
County of_Duval
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: Lot 4 and the West 22 Feet of Lot 5, except the Southerly 5 feet of Lots 4 and
5, BOWERY'S REPLAT, a subdivision according to the plat thereof recorded at Plat Book 20 page 22 of the Public
Records of Duval
Address of property being improved: 3927 th St Atlantic Beacb. FL
General description of improvements: ,
Owner: Verne Shortell Address: 392 7th St.Atlantic Beach, FL
Owner's interest in site of the improvement: ✓�
Fee Simple Titleholder(if other than owner):
Name:
Contractor:
AAddress:
y'/�%elq-�7�OF
Telephone No.: � ax No:
a Surety (if any)
Address: Amount of Bond$
Telephone No: Fax No:
Doc#2014050190,OR BK 16709 Page 1867,
Name and address of any person making a loan for the construction of the improvements Number Pages:1
Name: Recorded 03/06!2014 at 11:06 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Address: COUNTY
RECORDING$10.00
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:A ceyyP �j�/�Li/�S
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statue . (Fi 1 in at Own option)
Name: T�y�/�
Address: ,
Telephone No: 9W',77 s�� 7 742 Fax No:Expiration date date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Date:
Before me this- 1�day of fma , �,�/ in the County of Duval,State
personally Of Florida,has appeared
Notary Public at Large,State of Florida,County of Du
ORTENCA GJINI My commission expires: p
Notary Public,State of Florida Personally Known: or
Commission#EE 49709 Produced Identification:
My comm.expires Dec.16,2014
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 392 7TH STREET ATLANIC BEACH Permit Number:
Legal Description 20-22 16-2S-29E .230 BOWERYS R/P Parcel# 169914-0000
Floor Area of Sq. t. Sq.pt
Valuation of Work$ 7500 Proposed Work heated/cooled 2212 non-heated/cooled 656
Class of Work(circle one): New Addition =Alteration > Repair M'ovee Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial ` P�-�1Pn+ia1- ,
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # FL 10124R11
For multiple products use product approval form
Describe in detail the type of work to be performed: RE ROOF
Property Owner Information:
Name: HARVEY SHORTELL TRUST Address: 392 7TH ST -
City ATLANTIC BCH State FL Zip 32233 Phone: 609-651-7627
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: A CROWN ROOFING INC. Qualifying Agent: WILLIAM R. ROHN,JR.
Address: 392 SEVENTH ST. City ATLANTIC BEACH State FL Zip 32233
Office Phone 904-619-8790 Job Site/Contact Number 904-237-7424 Fax#904-646-1125
State Certification/Registration# CCC 1329521
Architect Name&Phone# I`l 10-
Engineer's Name&Phone# P 1A
Fee Simple Title Holder Name and Address liL-
Bonding Company Name and Address
Mortgage Lender Name and Address /✓ z&
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 oda 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 16)months at any time after
work is commenced. I understand that separate Per
must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, urnaces, Boilers,Heaters,
Tanks and Air Conditioners,eta
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 hereb certify that I have read and examined this a plication 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 ted 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.
c'//
Signature of Owner Signature of Contractor
� / l�
Print Name 4� '� L�......._cS. d .�. _ ......_........_.._.. Print Name �/�fsra .. k.. .,...._5 ,,........- _ .._
Sworn 115
Sworn to and subscr 1�i„M
This 'P 20 4 This M Day of Is l
tois K. _ otary PublicState of Florida
_ �tefacy-Public-State of Florida �'�F �`' commission#EE 84797816
No ry r �J Commission M EE 847t 30 978 Notary u 1C '•.,o��
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