1882 Hickory Ln roof 2014 CITY OF ATLANTIC BEACH
Is1
800 SEMINOLE ROAD
r) ATLANTIC BEACH, FL 32233
J
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000603 Date 4/17/14
Property Address . . . . . . 1882 HICKORY LN
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7755
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Application desc
reroof
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Owner Contractor
-
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ALLEN, KATHLEEN ET AL TOWNSEND ROOFING &
HICKS EDWIN CONSTRUCTION SERVICES
1882 HICKORY LANE 10418 NEW BERLIN RD # 115
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32226
(904) 645-0796
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 7755
Expiration Date . . 10/14/14
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Special Notes and Comments
need noc
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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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: I $$
--7
K j LA ri e. Permit Number:
Legal Description 3�7d �j'ZS Z�11� ���' UiJ Z'Q + Parcel
g p ' or-Area of Sq.Ft
Valuation of Work$�ss 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
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes N/A
Florida Product Approval# 1%L 1012
For multiple products use product approval form
Describe in detail the type of work to be performed: 604 PL 1h ce14_WPA4
CA E _j;,v��cr % � W i d 5`�� ks �� � �s`�i�k r�vw�c►���� ,.�ti� L 3 �s
Property Owner Information:
Name: �A A 1 1 GN Address: $g N I Lko he
City im A-N aA+<< L State ip 333 Phone
E-Mail or Fax#(Optional)
Contractor Information: ( j L
�111'110'1�1
l,'`rSTftic'M 9fNce),pQuali in A ent: h�y t
Company Name: � g g �(1� State�L Zip 3 Z�Z b
Address: D` UAt►S City ac kscx� ` F
Office Phone °i0 g�-bq S- 5 ig7 Job Site/Contact Number G..� i-f 7Zq(- 1J Fax# )O�f— L15-5 j yZ
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 is hereby made to obtain a permit to do th6 'te work and installations as indicated. I cert 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 al!laws rpegulating construction in thpiseriod diction(. This permit becomes null
work ls�ommenced.k is of I understand that sepad thin �a a per s m st be secured for Electrical Workd Plumbing,Signs,aWells,Pools,XFuinaces, Boilers,months at Heaters,He ers,
Tanks and Air Conditioners,etc-
WARNING
tcWARNING 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
BE OR ENTE RECORDING YOUR NOTICE OF
I here b certify that I have read and examined this a plication and know the same to be true and correct. All provisions of law ordinances governing this
type olYwork well be complied with whether specs sed herein or not. The granting of a permit does not presu to give ori to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
c° Signature of Contractor
Signature of Owner � � /
Print Name Print Name �,a y oW ytse rtd .........._......_........_.......
_... ....._ -Vie' -- 1 - ......._... -----......_. ............. _..... -- -
Sworn to and subscribed before me ,� Sworn t and subscribed1before me 20' j
this�Day of A 20 thi ay of I
n
Notary Public .�*Y►� q.l�MWNSEND u My Coir.EOM way 10,2017
MY COMMISSION N FF 092654 6.
* * EXPIRES:Match 25,2018 d Two NOW Mdry AWL
sw&dTtnk,*NoarySmicn
Apr 1714 01:08p Townsend Roofing 9046455442 p.1
Doc 1t 2014082005, OR BK 16749 Page 1585, Number Pages: 1, Recorded
04/15/2014 at 10:18 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
it t:"•.c. /7— o a3 Tax Folia No- 17202£0-130
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COMMENCEMENT
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