2378 1st St 2014 roof garage r��V
x f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000499 Date 4/02/14
Property Address . . . . . . 278 1ST ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2320
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Application desc
reroof garage
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Owner Contractor
-
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BERGERON DAVID K & JENNIFER CBI CONSTRUCTION (ROOFING)
278 1ST ST 5472 FIRST COAST HWY STE 6
ATLANTIC BEACH FL 32233 FERNANDINA BEACH FL 32034
(904) 302-8606
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . 65 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 2320
Expiration Date . . 9/29/14
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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 65 . 00 65 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT r
State of 'I""�V 1- Tax Folio No. / / 25 7
County of D-111:
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:
Address of property being improved: S+ tl FL- 31-2. 3
General description of improvements:
Owner: Vau 4c G".eca Address: 2.1 g )� S-h E4C e- f 1r.
Owner's interest in site of the improvement: Ariio�l/ /
Fee Simple Titleholder(if other than owner):
Name: n
Contractor: G13--t n
Address: H-7 a �7 c 5 ' 6,cco4 H c A � � (o i•f Y� rr-1�`a 1✓�' ���o c{t Wil.- 5 d OW
NTelephone No.: Ll e'L{ " �" '$�GZv Fax No: qw� - 3—71
Surety(if any)
Address: Amount of Bond$
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 oft
d
lf
erson within the State of Florida, other than himself, designated by Doc#20,14011 I-0`,OR t3K 16736 Page 1030.
p Number Pages:1
Recorded 04,-02 2014 at 09:31 AM,
served: Name: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Address: COUNTY
RECORDING$10.00
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Date: 3/Z j11q
MWMney Before me this gX day of MhfI\- in the County of Duval,State
:011"P1jq swe Of FIOt cla Of Florida.has personally appeared D—KI
My Commission Expires 07/17/2016 Notary Public at Large.State of Florida,County of Duval.
•FOF a No.EE 217314 My commission expires: 0-110111,
Comnlisqslon Personally Known: or
Bonded Thru Notary Public Underwriters Produced Identification: Rt_ OL
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: )'�S F�ec-1 T-- - ,32833 Permit Number:
Legal Description Parcel#
q
oor rea o q. t. . t
Valuation of Work$ OiSaoaoProposed 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 #
For multiple products use product approval orm
Describe in detail the type of work to be performed:
Property Owner Information:
,,� Address: v2-7 9s4
Name: LL3 Phone
Cit} State FLZip
E-Mail or Fax#(Optional) COQ
Contractor Information:
Company Name: G"3.� ���3ti� �" X7/0& Qualifying Agent,
Addressyr� 17a C'ir5} CacLs-t I-1w�9 Ste (9, City F=-l: JPcoc�
State Zi
Ll
Office Phone qY4-3ka - '9(06(. Job Site/Contact Number �'Ot-/'�o"�a"
760? Fax# SOLI 3-)9" 3��6
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
that
work
r installation has commenced
the
Applicationis
hereby
rr b and that obtain will bejperformed toomeet the standards of all lark and installations as ws tregulating onsstruotion inothis jurisdiction. This permit becomesrior onull
issuance p pp
and work void
o work is not
/ommenced within six understand that separate permitsomt st be secured for Electrical Work, Plumbing, Signs,aWelis, Poeriod ols,XFurnaces,sBoilerat ays,t time
Tanks and Air Conditioners,etc.
WARNING TO OWNER: D N YFAILURE OUR PAYING TWIRECCE OR IMPROVEMENTS
A NOTICE OF
COMMENCEMENT MAY RESULTCONSULT
TO YOUR PROPERTY. IF YOU INTEND EFORE RECORDING YOOBTAIN UR NOTICE OF H
YOUR LENDER OR AN ATTORNEY MENCEMENT.
n and ihereb workiwthat I have read and ill be complied with whether specified this
eciaedlhertein or not. Theegranting of same to be to permit does e and cnot prt. All esumejto gons ive autholaws rity
to j violatences gor cancel the
type o/Y p
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner
Signature of Contractor !�/•�'�� �a�' �—
Print Name V✓/ /✓....j�+�li �...
.......................
PrintNamea�.�. ........... �S.Co..^...................................................................
Sworn to and subscribed before me Brett ftney Sworn to and subscri d before me 20 /Y
this Day of 1
p„Pp this �Day of
" My Comm=EreS 07/1712016 r"��ROS MOORE
�� 4 Notar c TARYPl16UC
Notary Public ''�oF�°� orrimSTATE OF FLORVA
Bonded Thru Notary Public Underwriters .
Expifft 3,21/2018