340 1st St 2014 ROOF CITY OF ATLANTIC BEACH
y
800 SEMINOLE ROAD
r s) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
14-00001241 Date 8/05/14
� 340 1ST ST
Property Address . . . . .
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 7500
------------------------------
Application desc
FL 10497 .
-----------------------------
Contractor
Owner _
KLEIN ET AL, ELIZABETH NORTHEAST FLORIDA ROOFING INC
C.O RAY M KLEIN 178 PINECREST CIR
SAN MATEO FL 32187
3661 SW THISTLEWOOD LAND
PALM CITY FL 34990 (386) 937-2598
----------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 90 . 00 7500
Issue Date Valuation
Expiration Date 2/01/15
--- 2 . 00
Other Fees
. . STATE DCA SURCHARGE 2 , 00
STATE DBPR SURCHARGE
Fee summary Charged
Paid Credited
. 00
Permit Fee Total 90 . 00 90 . 00 . 00
Plan Check Total 00 . 00 . 00
4 . 00 . 00 . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 94 . 00 94 . 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
JobAddress: 3YJ E'r sL 2Permit Number:
Legal Description 5-49 :21-25 -29T 6t+le'yrFt'c Q �ti Parcel# 10 -7q-3-6000
oor ea o q. t. Sq-Ft
Valuation of Work$ �,'SGa 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):iCommercial eside
Tiu N/A
If an existing structure,is a fire sprinkler system installed? (Circle one): es No
Florida Product Approval# 10y47 Al
For multiple products use product approval orm
Describe in detail the type of work to be performed: Peron-F .(t,) _,11
Rao- S
Property Owner Information:
Name: Address:
CityOtbnfir, R C StateF!�,Zip3 Phone 90-1- St a
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: a.4 Qualifying Agent:
City S a o State Zip 3-21 87
Address: r)l6 I S�jg Fax#
Office Phone Job Site/Contact Number �$'� 1 �'
State Certification/Registration# G
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
that
work or installation
rior
isthe
euancelof a permitand that allmade to bwork wlll belperfot to �med tothe omeet the standards of all ark and installations as lwstregl latined I g onsstru�c'on in this jurisdictions This permit becomeson 11
and void if work is not commenced within six e months, or if construction or work is suspended or abandoned for aperiod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces, Boilers,Renters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT N YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND
BE ORE RECORDING YOUR NOTICE OF TO OBTAIN FINANCING CONSULT H
YOUR LENDER OR AN ATTORNEY
type ojYwcertify that I have read andork will be compli d with whmlerspecified this lherein or not.ication and The granting of asame to be 1per d doescnotprt. All esumeitns of laws o jry to vaiolatences gor canceltthe
law regula in construction or the performance of cons }jct�o �� 'p
provisions of any other federal,sta r l cal
Signature of Owner '
Signature of Contractor
Print Name _ Q, .......k�v.l.........................................................................................
Befo Print Name ........ � .. .........Pn. �..................................................................
19
Before nne 20 Itf this Day of 20
this 5 Day of a�u5
Notary Public KRIstIw+
."4: ComnJss'ia+0EEB6$9g6 �„ JENNIFER WALKER
Expires January a�.241 s ;; '� v My c()MMjss10N a FF 0114 Revised 01.26.10
„f„' S,,4,dThNT Fanlmuta�R@ 5' =* EXPIR April 24,2017
., .e Bonded Thru NOW Y Public UndarwtNeli
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State Of Florida
County of UllVal
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:
i �'
Address of property being improved: f() F
General description of improvements: Remove one layer 20 year shingles,wood repair,install new single layer
modified bitumen roofing,metal edging,new pipe boots
Owner ��
Address 3 0 first Street Atlantic Beach Florida
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
1 Name
/ Address
CoNorth East Florida Ruofing Inc.
Address P.O.Box 37 San Mateo Florida 32187(CC 1326784)
Phone No.386-937-2598 Fax No.
rety pf any) Amount of bond 5
Address
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements-
Name
Address
Fax No.
Phone 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
Fax No. '
Phone 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 is specified):
_ W IE LZJPq
THIS SPACE FOR RECORDER'S USE ONLY DATE -1 �1
i Signed: in the
Before me this day of
'Po'ry) Co +ofAwee o161oJi r oral y P a 7heretn by
himse;: ersed and affirms that all statements antl decterations herein
are true and accurate
Doc#2014174206,OR BK 16867 Paget 14, _cA
Number Pages: 'I Notary blit Larg .state of ounty or r
Recorded 08/05 2014 at 12:53 PM, mycomrnission exp' s:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Personallyced ldK-niR�
COUNTY
RECORDING$10.00 Pp.Peen A�RErA,KNQ?T
r
_ 1 Fo01ic-Stile M Floral
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