1852 SEa Oats Dr 2014 Roof CITY OF ATLANTIC BEACH
t
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r
Application Number . . . 14-00000669 Date 4/28/14
Property Address . . . . . . 1852 SEA OATS DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7500
--------------------------------------------------
Application desc
reroof
------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
HAESELER, ERIC LEONARD & A CROWN ROOFING INC
HELEN PHYLLIS TRUST 2159 ST JOHN' S BLUFF RD S
% ERIC L & PHYLLIS HAESELER JACKSONVILLE FL 32246
ATLANTIC BEACH FL 32233
-----Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 90 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 7500
Expiration Date . . 10/25/14
--------------------------
Other Fees .
_ STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
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: 1852 SE-19 C)/9T5 DP-. PL-. 322-33 Permit Number:
Legal Description 3(°L20 -a5-- U aj 1 o 9 Parcel# ZO20-2
Floor Area o q. t. q.
Valuation of Work$ �lS Proposed Work h' ted/cooled non-heated/cooled �T Y"t�
Class of Work(circle one): New Additio Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposedstructure(s)(circle one): Commercial Residential
If an existing structuri
e, s a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval I/Plol
For multiple products use product approval form {{
Describe in detail the type of work to be performed: e 1oo t✓1 e.5
Property Owner Information: 3
_ 3229
Name: Ekt C H l4 ESE—LE I2 Address: 1852 SEH a'ffS D1?. f+7U9nT7C_,8eHCA'f FL_
City t9TL,r4rTrlc R e19-r-t+ StatelE�=Zip 2L3 Phone 9�Oi-1-(v!4-879(7 90'f 38tio-208/
E-Mail or Fax#(Optional) QO4- (y rfln-11 a�
Contractor Information:
Company Name: A 0-0-OWN "F/N _174 C- Qualifying Agent: 0 rl-t-/" 2. 9-00N,J le .
Address:-/5-1 ST.j0t/NS bLUFr_ ISO S. City JI`tC"0Njt/tlt-F_ State FL- Zip .32Z4t(o
Office Phone 90q-(o/9-@ 7 9Q Job Site/Contact Number Fax# Sa4-(0!-f(o-ll2 S
State Certification/Registration# 6CC/,Aa9,5--')-/
Architect Name&Phone# N/!4-
Engineer's Name&Phone# Ao<�
Fee Simple Title Holder Name and Address NKA4_
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 all laws regulating construction in this jurisdiction. This permit becomes null
and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for ElecMc Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etG
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 hereby cert that 1 have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o1 work will be complied with whether speci:ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of arty other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner _ Signature of Contracto
Print Name �- ` S 2� Print Name /// `
............_..........................................(................................................................................ 1..�..i.,., �.ee.�f1.... a'.............. .. .r.••• ............................................
Sworn to and subscrib d before me Sworn to and subscri ed before me
this ay of 0 /4/ this.2Z Day of ✓i/
01 0 Y PI,,
O� I� _ QCf ,�*� «°��' LOIS K.NELSON
?• • NO Public ;v M u is-State of Florida
tary UbliC _ Notary Public-State of Florida �' ;9 y Comm. Expires Oct 30,2011
?Nr :of My Comm.Expires Oct 30, 2016 'i�i5�d Ol.f&'T Mon #EE 8479'78
Commission# EE 847978
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE(
Permit No. Tax Folio No.
State of Florida 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: 3`+' �7' 2 S a•-9E_
SEL✓g MjQ>t2/N1Q L(!V !T No 4
Address of property being improved: 6-572— 5th DffrS D2 -
)4-FL4grrr-j L Jit-3-c.tf- F-�_ 32-2-3 3
General description of improvements: RE-ROOFING
Owner L+?/L k4 r4ES'ELE2.
Address Z S 0i+7-S DPe. 1744NT7C-/3L?9-ctt--FL-3 22 33
Owner's interest in site of the improvement t
Fee Simple Titleholder(if other than owner) /� t
Name
Address
n� Contractor A CROWN ROOFING,INC.
n' Address 2159 ST.JOHNS BLUFF RD S,JACKSONVILLE,FL 32246
Phone No. 904-619-8790 Fax No 904-646-1125
Surety(if any) N/A
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address
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 ACROWN ROOFING,INC
Address 2159 ST. JOHNS BLUFF RD S, JACKSONVILLE, FL 32246
Phone No. 904-619-8790 Fax No.904-646-1125
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' t Owner's option).
Namet�.dd/I� -
Address —7
Phone No. "�ZAL-ZZ�D Fax No. _� / 7oZ--
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 O ER/. ` r
Signed: v DATE
Before me thi S day of .�rI ZILs/4 in the
Doc#-1,014093499.OR BK 161-63 Page 283, County of DuvalEitat of Florida.hos ers
L au. herein t,,
Number Pages:1 himself'herself and affirms that all statem s ns herein LOIS K.NELSON
Recorded 04.2812014 at 03:16 PM, are true and accurate ; ;s Notary Public-State of Florida
Ronnie Fussell CLERK CIRCUIT COURT DUVAL �' ' -' My Comm.Expires Oct 30,2016
COUNTY
RECORDING$10.00 io Commission EE 647978
otary Public at Large.State of CL_ County of
Aly commission expires. 10—3b—f V
Personally Kno,.n
Produced Identificationi�gOR_ L-JLEIVS