160 BELVEDERE ST 2014 ROOF CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001193 Date 7/25/14
Property Address . . . . . . . 160 BELVEDERE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6440
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Application desc
REROOF FL 13S6 . 3
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Owner Contractor
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MCNEILL, SHEILA SHORE ROOFING COMPANY
160 BELVEDERE 914 7TH AVENUE SOUTH
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 241-8842
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6440
Expiration Date . . 1/21/15
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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 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 1740S77 -c000
State of I r-1 County of.
To whom it may concern:
The undersigned hereby informs you that improvements will be made to c-ertatit real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICFz OF
COMMENCEMENT.
Legal description of property being improved: 10-9 SA-/t'4'A- 4rc
Address ofproperlybefng improved: /60 t3C-'1V1 T'ed '34*�f'
General description of improvements:
Address 1&49 j3C-1&1�tjCjrC- s
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner) <
Name
G) M
Address 0)
Contractor.. SAarc, to
0- 0
Q
-A Address to
Phone No. Viii 2- Fax No. �0 Z)
Q
Surety(if any) Q�
Address to\1
Phone No- mount of bond Cr 0
Fax No. Lu q
-j 0
to
Name and address of any person making a loan for the construction of the improvements. z
Name
a) 4)
Address -2�T z C)
E 0
Phone No. Fax No. 0 -5 a) 0C 0 Uj
0 z W of
Name ofperson within the State of Florida,other than himself,designated by owner upon whom notices orother
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!he date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY
DATE
Before rne is dayif
11 in the
C,ou ty of Duval.Sate offforida,has pe nallyappeared
.,n
da.h..oa..,Iy.�pneare,j
herein by
PAMELA JEAN SHORE ftinselft herself and .......s th-t all statements and declarations herein
Notary Public-State Of FI*Wida are true and accurat,
MY COMM.Expires DOC 4.2017 1
COMMislion FF 074537
No ary Pubfic�at Large,Sta of
MY commission expires:
Personally Known
Produced fdentifiicaijion��-- or
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: c I v cdejee— Permit Number:
Legal Description W 5#4-4-AL Parcel# /70�E77-03CPd
�1& Floor Area of Tq.7. Sq.Ft
Valuation of Work$ 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 Residential
If an existing structure,is a fire sprMer system installed? (Circle one): Yes No N/A
Florida Product Approval# /90. 3
For multiple products use procluct appro
Describe in detail the type of work to be performed:
h4t/0 P"t' l
Property Owner Information:
Name: Shl go
,.j/04- MCA,; Address:
city t-k- i3irrre-h StaW�Zip� -33 Phone V63-41161
!213,3
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: SAge c ROOF;ey 0-4) Qualifying Agent: —Am.4,f
Address: W &L�.'ns2&V 44A,(_ -city 4e%Ck State /_1 Zip 6ZZro
OfficePhone 2w-9741- Job Site/Contact Number .7
State Certificatio�/Registration JX o SL4 ff I �t6_ 2,015`7 Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to do the work and installations as indicated. J certify that no work or installation has commencedprior to the
issuance o
,)�aopermit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void rk is not commenced within six(6)months, or if construction or work is suspended or abandonedfor eriod of six(6)months at any time after
work is commenced. I understand that separate permits must be securedfor Eleetricar Work, Plumbing,Signs,awl 11s,Pools, Furnaces,Boilers,Heaters,
Tanks andAir 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 13EFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here certi
,lb fy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type ) work 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 otherfederal,state, or local law regulating construction or the pe�formance of construction.
Signature of Own 0- (2. Signature of Co�ntractor It
Print Name i.�- Print Name
C, ......... ... ...
... ......... ...... j' ........ .. .. . ...Mj.g.
................ ... ................................. . ... ... .. ..........
Befor 4ie Be
this D cif 2 J-/- t h i'fT A 204
4 [Azli PAWM�_ - d--A-
N-olfary Publi .w Akri j riotary ruvoc-state oi moniff qubli(PKkNDRAM-TOLM
My Comm.Expires Doc 4,2017
My COMMISSION#EE 04 5
14
or F�,, Commission# IFF 074537 EXPIRES:December 21,
blic Und vised0l.26.10
P111 01 Bonded Thru Notary Public Und