2212 Barefoot Tr 14-00001346 roof CITY OF ATLANTIC BEACH
ij 800 SEMINOLE ROAD
rJ � ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001346 Date 8/20/14
Property Address . . . . . . 2212 BAREFOOT TRAC
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 18300
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Application desc
reroof
--------------------------------
Owner Contractor
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------------------------ ----------
MEAD, LARRY E AND SUSAN A SHORE ROOFING COMPANY
2212 BAREFOOT TRACE 914 7TH AVENUE SOUTH
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 241-8842
----
-----Permit
ROOF PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 145 . 00 18300
Issue Date Valuation
Expiration Date . . 2/16/15
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-----------------------------------------
2 . 18
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 18
________ ----
Fee summary Charged
Paid Credited ----Due---
--
----- ----------
- . 00
Permit Fee Total 145 . 00 145 . 0000 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 36 4 . 36 . 00
Grand Total
149 . 36 149 . 36 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMEN P
(PREPARE IN DUPLICATE)
J
Q
( Permit No. Tax Folio Na. /�- T ' d ��
D State ofj-=1_ 1 County of j ,,IjW�
ra r
cr To whom it may concern:
(> O The undersigned hereby informs you that improvements will be made to cert-fr -eal property,and in
(o Q H accordance with Section 713 of the Florida Statutes,the following information is t•'a'F d in this NOTICE OF
10
ra O D COMMENCEMENT.in 00 Legal description of property being improved: —03 09 -A 5 — 7
of m Y
(.l d'W OO ..
f h N J O _
o m o Address lofproperty bein mpravedi: /� [�/'�►�Z
LL
Z O General description of improvements: RC-R&O
o � (D oOw
t�ZU�
Owner rr
Address -i
JAI'C. Y9C( L CyC,� /-� ��Z3
Owner's interest in site of the improvement_
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor .Shv/t_ I G'V __
Address LJ r-r..r`/ L/✓� ��/yY4� L �1?'�/5�� /9 -Z1f G
Phone No_ 2L41- ul�'1 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 Lierror's 1, 3 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 o -xding unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER ri/
Slgned DATE v
Before me Is y in the
.C unty of Dwal,Stale�1� ,'Ih s peisonally appear
herein by
himself!lierse and afO [elements and de- herein
PAMELA J are true and accurate
SLA ry
.S NohrY Fub -S 1
MY Comm.Exp)res Oec �,
ComrtliEf�n FF ,�?� o ary Pub(cat Large,Stat C unly of
07�53�. My commission expires: - .-
Personally Known or
Produced Idenrrrication
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: a a1A (3RrtFwo 7�'A _C Permit Number:
Legal Description 4A-1_309 'as --d i tE3 7-,�5 a 9 L Parcel# 169W-3_0590
oor Area ot Sq.Ft. �t
Valuation of Works /1 3100 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 structures) circle one): Commercial Residential
If an existing strucure,is a fire sprin er system installed? (Circle one): Yes No N/A
Florida Product Approval# AA
For multiple products use product approval orm
Describe in detail the type of work to be performed: PO,F 130)LeIc-r
rry I I_ d K
Property Owner Information:
Name: Address: l
City r State /Zip X123_3 Phone yG— 9y�—
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Aol2C, f�y Qualifying A ent:
Company Name: � d J l Qli�' g
Address: 3 •'i w►� �'� City J/R'�2f ece_4 State /'I Zip 322-x4
Office Phone nZ L/ —iM22 Job Site/Contact Number Fax#
State Certification/Registration# C°CG O,0 01
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. I 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 workisc ommenced.not
I understand that separate permits mor ut be secured for Electrical Work,construction or work is �Plumb ng,Sigor ns,or aWells, P period olsx �ernaces,Boilers,months at tHeatime ersr
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 hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o) work will be complied with whether speci ied 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 law regulating constr tion or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Print Name
Befor e L, e
this ' Day of ✓� •"""' ...ELA JEAN DFIWIde
Day of 20
:o
=:� = Notary Public-Statxpires D
otary Public Corwi.ssion a Friblic
r-6-1r-%V-,m ° - Revised 01.26.10