162 Camelia St 14-00001097 Roof 7
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001097 Date 7/09/14
Property Address . . . . . . 162 CAMELIA ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8100 --------------
-------------------------------------------------------------
Application desc
reroof
----------------------------------------------------------------------------
Owner Contractor
------------------------
------- -- -- --- ---- -
WINDLEY-JR ET AL, JOHN S GREAT WHITE CONSTRUCTION INC
CLAPP SUSAN 1 4320 DEERWOOD LAKE PWY
162 CAMELIA ST JACKSONVILLE FL 32216
ATLANTIC BEACH FL 32233 (904) 838-1659
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . . 00
Permit Fee . . . . 95 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 8100
Expiration Date . . 1/05/15 --------------
---------------------------------------------------- --------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 ' 00 . 00 . 00
other Fee Total 4 . 00 4 * 00 . 00 . 00
Grand Total 99 . 00 99 . 00 . 00 . 00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV 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:/03111, vad 1;2)1016 6—��ermit Number:
Legal Descriptionq d �"larcel# 7- 12DA6,60
�( �q
n�L��reafo
0 oor a o t t
Valuation of Work$ - Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair MojL Demolition pool/spa window/door
J��
(circle one): Commercial sidential
s
Use of existing/proposed structure(s) Q4s 0
If an existing structure,is a fire sprinkler system installed?(Circle one): Q62D
Florida Product A �proval# 10 1 ;IJ"-L(o
For multiple prosucts use product approval form
Describe in detail the type of work to be performed:
Pronertv Owner Informatim
f
Name 1 -1 IS t log
a, - __��ddress:
citylm —StatqWip.9�1a;24hone !I W 3
.1 ,- Oka
E-Mal or Fax#(Optional)—
Contractor Information:
Qualifying Agent: -I-Vrk lji�
UI�1-
Company ar I I f L 7�ip—�)-w I
Address: in LA Job VKJJYN nw ity �,�jo State
' 1 _L� ,
Office Phione Job Site/Contact Numbe;b���� I- ki
,.f
, /R on 4
State Certification/Registration# (35mml
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 obtaina permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will bepedbrmed to meet the standards ofall laws regulating construction in thisjurisdiction. This permit becomes null
f construction or work is suspended or abandonedfor a period of sixg months at any time after
and void if work is not commenced within six(6)months,or i
work is commenced. I understand that separate permits m�st be securedfor Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,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 BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here�certify that I have read and examined thisfa lication and know the same to be true and correct. All provisions of laws and ordinances governing this
I authority to violate or cancel the
work will be complied with whether speci Ned herein or not. The granting of a permit does not presume to g ve
provisions of any otherfederal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name .......... PrintName -Travis ...................................
......... .......
Sworn to and subs *bed before me Sworn�o and subscribed bef, Iq
'aysuf this __L Day of_ j�Me .20
tNs.j Day of's ..k �20 jq
t Public No U ic
- -c
e,is .26.10
S-UMNIEL"NEBLMCHARD
MY COMMISSION#FF115171
EXPIRES April 22, 2018 PY4.%. ASHLEY RIDGEWAY
�407)3N-0153 FloridallotaryServicezorn Notary Public-State of Florida
My COMM Expires Jun 20.2017
Commission 0 FF 29966
M,
Doc # 2014152247, OR EK 16838 Page 1853, Number Pages: 1 , Recorded
07/09/2014 at 11 :41 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 -00
NOTICE OF COMMENCEMENT
�P�PAIREIR C1ijr1v-*-1AM
plerry-IN"- 74X Folin 4Q
'0i 1. —1. 1 �''. �. '. I
$tmt
To whom It
The undarsigned hotoby W*fts You that IWOM04fth*111 b*nud*to Cwtilin ro-31 PrOpertY,4ntl in
accordan"W0 300*tl 713 of the FWkfm Statutes,the k1lowing inf*tmatk-A ts Voted in this NOTICE OF
coMMOMEMENT.
1 ;;5-2 Su-
Lt%,Wd$SV't00S
Aga
ba,
Owser A)a OA rk
�m of tv*illnpftnvenwnt '0W
r-#t�%,*Mje T
-------------
Address
$�xet�0�arty"
A'Miess-- --A-nowt of bvnd
!>t�ar*.No- Fv N-��
,Name ard aadr*ss,.f any perwrmakiln a'�vw.fb�ths constructic-0 tv�Mpf*V*TsWnts,
'N'afrse--- --
----------
ptxme No., Fax No.
�e State of pfo"i. itlan mmw...,ats;�#,r*W,,y oemer wbo.T.rottices c-f offier
Same of t,
dtx�-'uneqts may ne"tlwed:
Al
&-.�jnatvs the
'da S, 'l ir 0
Swic-rlk 713.06, 2Mb*,-F.W., tatutts,zFq atC r*r si=M
N, am.,-
2
Md,,ess
0
Prvle
Fva*atior clateof Naii"of 4�W,-
Oate�5 sv*4�.vfivd-"�
-b 0*'.'
-------------------------
STEPHAME Lmt*juKKQ
EXPIRPS April
0M
Xvr
2
VNI
kas:
........... ..................
..00- ............