1393 Beach Ave 2014 Roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
lit
Application Number . . . . . 14-00000456 Date 3/26/14
Property Address . . . . . . 1393 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 22000 ------
----------------------------------------------------------------------
Application desc
reroof --------------
-- ----------------------------------------------------------
Owner Contractor--------------
----------
------------------------ JUSTIN LARSEN CONSTRUCTION INC
EASTON/ WILLIAM & JILL PO BOX 1942
1393 BEACH AVENUE
ATLANTIC BEACH FL 32233 4784 CATTAIL ST
MIDDLEBURG FL 32068
(904) 241-0320
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Permit . . . . . . ROOF PERMIT
Additional desc . - 160 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 22000
Issue Date . . . .
Expiration Date . - 9/22/14 --------------------------------
--------------------------------------------A SURCHARGE 2 .40
other Fees . . . . . . . . . STATE DC
STATE DBPR SURCHARGE 2 .40
------- ---------------------------------------------------------
- -------- Paid Credited Due
Fee summary Charged ----- ----------
------ ------
------ --- -----
Permit-Fee-Total ----160 . 00 160 - 00 . 00 . 00
plan Check Total . 00 . 00 . 00 . 00
other Fee Total 4 . 80 4 . 80 . 00 . 00
Grand Total 164 . 80 164 . 80 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 M Aj_j�
Job Address: 13q3 &A �7 Permit Nu
Legal Description Parcel
r loor Area ot sq.Ft. Sq Ft
Valuation of Work S em, 000.1V Proposed Work -heated/cooled non-heated/cooled
FRM'Al-1�7
0 qTM
Addition Alteration Repair Move Demolitjio � alt4aMi;windowl
-Class of Work (circle one): CED jj� I
Use of existing/proposed structure(s) circle one): Commercial Residentia 26 Z014
If an existing structure, is a fire spriler system installed? (Circle one):---Y-e—s .-o
Flor I da Product Approval
For multiple products use product approval form By
Describe in detail the type of work to be performed:
Property
..Owner Information:
Narnej. &jV Address:
City d�Siate &2ip.&W!13P_hone
E-Mail or Fax # (Optional)—
Contractor Information:
Compan- �]W Qualifyin A
k4e Zip
Addressj City State
Office Phone Job Site/qontact Number __Fa #
I io
State Certification/Reggistration 4 am!ff
Architect Name & Phone #
Engineer's Name & Phone Af
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 a s indicated I certify that no work.or installation has commenced prior to the
issuance it-and that all work will be performed to meet the standards ofall laws regulating construction in thisjurisdiction. Thispermii becomes/III//
0 1 2bondonedfor a period of sixj6)months of any time ofier
and void ifj�oPrek"i's not commenced within six(6)months, or if consArjuction or work is suspended or e
work is commenced. I understand that separate permits must be securedfor Electrice Work, Plumbing, Signs, Wells, Pools, urnaces, Boilers, Healers,
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
,I COMMENCEMENT.
hereby ce4lify that I have read and examined this application and know the some to be true and correct. All provisions qf laws and ordinances governing ihis
tvpe of work will be complied with whether specified herein or not. The granting of a permit does not presume-lo'-gii�ve a Vahori,,violote-or cancel the
provisions of any otherfederol,slate, or local law regulating construction or the peiformance of constructi on
SignatUre of Ownet Signature of Contr�actor
Print Name ....... ...
Print Narne 011
Swor I t an su cr'b be me S and sc *b d e me
'wo
his this C API
state of Florida
1A PUENTA N lic-
y li - of FIG Jan 26.2015
�otarV L liC My comm.ExPires Jan 26,2015 No #EE 59080
Commission#EE 59080
0.f
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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:
General description of improvements:
Owner
V
Address jj!"��!::�,:; lq-7 RL 5Q,25-53
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
contractor
Address Fax No.
Phone No!
Surety (if any)
Amount of bond $
Address
0
Phone No. 'FaxNo.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. EEE? 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
Address
Phone 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 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 from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY Signed: NER TE 3 in t e
Before me this ay of
County pi Duval,State of Florida, has personally ppeare herein by
D TE
himself/herself and affirms th tat rl2raWans--haLe
are true and accurate s e nt.%aud riecl—,
Doc#2014066125,OR BK 16729 Page 978,
y PU&I, MARIA PIMIENTA Fl orida
15
N ary
Public-state of Florida
Number Pages� I
M comm. Expires Jan 216,2015
Recorded 03;26/2014 at 09:41 AM, 0
59080
Ronnie Fussell CLERK CIRCUIT COURT DUVAL co mission#EE 59080
COUNTY
RECORDING$10.00 o ry u' ic at Large, tate 0 6-unty of
My commission expires: vp f or
Personally Known
Produced Identification