825 Sailfish Reroof 2014 CITY OF ATLANTIC BEACH
y 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
14-00000801 Date 5/14/14
Property Address . . . . . . 825 SAILFISH DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation 6000
-------------------------------
Application desc
reroof
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Owner Contractor
--------------
OVERBY, KELLY DAVID KOUTZ LLC
1219 THE GROVE RD
1360 EAST COAST DRIVE
ORANGE PARK FL 32073
ATLANTIC BEACH FL 32233 (904) 591-2356
---------- -----------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . plan Check Fee . 00
Permit Fee . . . . 80 . 00 6000
Issue Date Valuation
Expiration Date . . 11/10/14
------------
---------------------------------
2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
Fee summary Charged
Paid Credited ----Due
---
_ ------- . 00
---------- ----------
- . 00
Permit Fee Total 80 . 00 80 . 00 00 . 00
Plan Check Total • 00 00 . 00 4 . . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 84 . 00 84 . 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: ea S Permit Number:
Legal Description Parcel#
Ft oSOD. d' Proposed Work heated/cooled nn-heated/cooled
Valuation of Work$ �� p
Class of Work(circle one): (� Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) (circle one): Commercial esidential
If an existing structure,is a fire sprinkler system installed? (Circle one): o N /A
Florida Product Approval# Al, I b O L lL i t
For multiple products use product approval orm
Describe in detail the type of work to be performed: XcI nOv'C Eelisi,,;ULr 3 -7) 6 Id%�L'�S
!►1� L T A No n/� S fN Lrc S r €�9✓ lie-ltO A A l L &K Is i l.�JL- Peer_r TH
Property Owner Information: 6�_A AMI L,
Name:
J-0c eki7_X _l Address: t,)T Soq/L FI N
cityA%t Yl w r"7� se:we o State PL Zip 3 2 2 3 3 Phone 42 9 - 33&k
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: pAy D K0VTV LLC Qualifying Agent: A VIn
p yZip Z07
Address: 1219 j'-, lztQA%—k-- 040 city n �9 State —
Office Phone_91�`�-Syl'23Sk Job Site/Contact Number q 0-t-S51-2, Fax#
State Certification/Registration # ee S_6- 8
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 the work and installations as indicated. 1 certify 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 if 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools, urnaees, Boilers,Heaters,
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 BEFR ENTE RECORDING YOUR NOTICE OF
1 herebycertify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of ork will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local w regulating construction or the performance of construction.
IA- ,
Signature of Owner Signature of ContractoleA��'
L Print Name Y .1.0 kO.0
Print Name frb ..............................
............................ �.............. .............................................................
Sworn to an4 subscribed before me Sworn to and subscribed before me 20
this y of 20/4 this �)'D of
/ VALERY M GIDEON ' ' VALERY WI OIDEON
Nota Public Nota Public STATE OF FLORIDA
STATE OF FLORIDA
C4
Comm#FF086458 CWr* I!W.10
Explree 1128/'2018 ExWrN 1nQ/Z018
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of 11=L 09—i Q A County of V A LI
To whom it may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and in
accordance with Sectlon 713 of the Florida Statutes,the following Information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 5,4" A"'ATr4
Address of property being improved: r r�Lt c, l Lj-�1StL
1-x,
General description of improvements: 0z-R�Jp
Owner �� L V,--ICA Y
Address S SO AIFI-�h )IC �C EI 3223 3
Owner's interest in site of the improvementL
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor DAV10 140tsT'--* LLC..
Address 17-11 "TH it (SRLZVF- Rte b,P 'irL 33.0"T 3
Phone No. ��i 2 3��;C Fax No.
Surety(if any)
Address Amount of bond$
Phone 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 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 iG snecifed).
Doc#20114104927,OR 8K 16778 Page 374, WNER
Number Pages: i 1 Signed: DATE S `�
Recorded 05/1312014 at 08:49 AM. Before me th ��day of fMt+3� in the
Ronnie Fussell CLERK CIRCUIT COURT DUVAL County of Duval.State of Florida, personally appeared
.1t>6 atern nh,if—u Harem by VALM M OIDEON
COUNTY himselV herself and affirms that all statements and declarations he
RECORDING$10.00 are true and accurate NOTARY PUBLIC
STATE OF FILOMDA
County of WAN 1/2WO19
i Notary Public a Large.State of Y
At c ission expires: /^2to
ersonaiiy Kno', —_
eeea-t ...anon_ --- _. —.