1175 Seminole Rd 2014 roofCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000697 Date 5/02/14
Property Address . . . . . . 1175 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7200
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Application desc
reroof
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Owner
NAUMANN LIFE ESTATE, ANNELIESE
% KEITH NAUMANN
908 PRINCE PHILLIP DR
VIRGINIA BEACH VA 23452
Contractor
MACK BROTHER GENERAL CTRS.
5521 BARKER STREET
JACKSONVILLE FL 32207
(904) 237-0868
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Permit . . . . .
. ROOF PERMIT
Additional desc .
.
Permit Fee . . .
. 90.00
Plan Check Fee
.00
Issue Date . . .
.
Valuation . . .
. 7200
Expiration Date .
. 10/29/14
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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
.lob Address: 1175 Seminole Rd. Permit Number:
23-4 16 -2S -29E Selva Marina Unit 1 Lot3 Blk
Legal Description
r toor tsrca of ay. r i. 04.1
Valuation of Work $ -7ZOD . Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition AlterationRepair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one):iCommercial e i t'
if an existing structure, is a fire sprinkler system installed? (Circle one): cs No N /A
Florida Product Approval # �4 / 1 S to . 1 . AL 10 3�r 71 f(-6.) 6 7' /
For multiple products use ppro�{c be approtal form t/
Describe in detail the type of work to be performed: / a 5'G u 4-I eS R� goo
Property Owner Information:
Name: Phyllis Arnold Address:__ P.O. Box 11508
City Jacksonville StateFLZip 32239 Phone 904-502-3414 _
E -Mail or Fax # (Optional) -
Contractor Information:
Mack Brothers Building Contractors, In , fy. g g Frederick W Mack
Company Name: -. It in A ent:
Address: 1546 Girvin Rd Unit 1 City Jacksonville State FL Zip32225
Officc Phone q o 4- .. 0- 2 g n n Job Site! Contact Number 9 0 4- 2 3 7- 0 8 6 8 Fax # 9 o 4- 2114 - 05-10
State Certification/Registration #_CBC 12 5 8 0 6 2
Architect Name & Phone #
Engineer's Name & Phone #
Fcc 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 as indicated. I certify that no work or installation has commenced prior to the
issuance of n permit and that all work wii/ he performed to meet the standards of all laws regulating constriction in this jurisdiction. This permit becomes earll
and void r•'f ttvrrk is not commenced within si.r (6) months. or if construction or ra,ork is susp• ended or ahandonecd f v a enod of six (6) montll_c at tuty time after
work is comnrenccd. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Nlells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Canditianers, 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
COMMENCEMENT.
I hereby ce ritfv that i have read and e-ramined this application ow the same to be trite and correct. All provisions t f laws and ordinances governing this
type a work will be c» I'd kidt whether s ted herein or rrot. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany other a al, sta , or to aw r latin onslrre on or the performance of constriction.
Signature of Own Signature of Contract'
Print Namer1y s r n o C Print Name
_............................._.........._.......__.........._..................
__. fir. �,-f .�...._..............
Sworn to and subscribed before me Sworn to nd subscribed before me
this _ � Day of _ (a ,o , 20 this nbay of a n r, 1 .20 i Y
Notary Public Notary Public
PANFUL HRYNCEWICZ .a" w" PAMELA HRYNCEWICZ Revised 01.26.10
'yD' MY COMMISSION # FF 098164
MY COMMISSION # FF 098164 :.:
.•: `` 2018 �'. EXPIRES: March 4, 2018
'a EXPIRES: March 4, '? $r 1 Bonded 1hru Notary Pub!
Bonded Thry Notary Public Underwriters c Undenwrders
•; yy .'
May 02 14 09:45a Mack Brothers 904-220-0520 P.1
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No.
County of _Duval
To Whom It May Concenr
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:_ i3 _23-4 16-29-M&rj -n a - [IIIb -1t--1 L 0 t -Blk-1-
Address of property being improved: 1175 Semi
General description of improvements: roe
F.'"
Owner: Phyllis Arnold Address: P.O. Box 11506, Jacksonvil-e, FL 32239
Owner's interest in site of the improvement:
Fee Simple TiUcholdcr (if other than owner),.
Name-.
Contractor. Mack Brothers Building Contractors, Inc. --
Address: 15_41�ry n RdUnit 1
Ql jack5onville. FL 32225
. .
TcicphoneNu.: 904-220-2500 Fax -No: 904-220-0520
Surc(y (if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address of any person making a loan for the construction of improvements
Name:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or odv--r documents may be
served: Name:
-
Address: ------
Telephone No: Fax No:.-__-___ ��
In
o:. --
In addition to himself, owner designates the following person to receive a copy of tho Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
NHTne:
Address:
-------------
Telephone No: Fax No:
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of "wording unless a different date is
Doc 4 2014096839, OR 8K 1 e?67 Page 788,
Number Pages: I
Recorded 05101.Q014 at 0'1:39 PM,
Ronnie Fussell CLERK CIRCUIT COLR- DUVAL
COUNTY
RECORDING $10,00
NN
ncri: I— - N1,-1--,--t-� '-,0-
110M Mtis b16- of yI '32Z
Florida, has personally appeared ._..,
-- hy-1341- --J
Wry Public at large, State of Florida, Coubty of DUVI
commission expires: r1A-r,r--k Y, 01'
a-wsonally Known:
Produced I dent if ication:
PAWELAMYNCE"M
ABY COMMISSION # FF 0981164
EXPIRES March 4, 2018
SWW Thry WvyPubkU1,d4r11r1"
Vats:
1 the c9unty of Duval, State
or