387 6th st 2014 roof J� n CITY OF ATLANTIC BEACH
} 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001435 Date 9/02/14
Property Address . . . . . . 387 6TH ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 4500
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Application desc
FL. 10124 . 1
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Owner Contractor
-
------------------------
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FOURAKER ET AL, STEPHEN O D. S . KILLIAN ROOFING &GC (ROOF
387 6TH ST 3948 3RD ST S BOX 122
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 509-8470
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4500
Expiration Date . . 3/01/15
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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 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 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: 3 6'r— e a k FL 3 Nermit Number: iq
Legal Description �Poroo�rpos�ed5�Work�h
LParcel# _ bt. q. tValuation of Work$ - eated/cooled _ non-heated/cooled
Class of Work(circle one): New Addition Alterati< Repair Move Demolition pool/spa window/door
Use of existing/proosed structure(s) ((circle one): Commercial Residential
If an existing structure,is a fire sprinklerystem ins lled9 (Circle one): Yes No N/A
Florida Product Approval# -FL
ble
For multiple products use product approval orm
Describe in detail the type of work to be performed:
Property Owner Information: y FL
Name:
ICV ee Address: �� ,
City Stat rZip Phone •?`{
E-Mail o Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
r
Company Name: L�` r ^ ivalifyin Agent:
Address: �� City State Zip�C
Office Phone O� ob Site/Contact Number Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
t no work or installation has commenced
rior
is�uatnaet f a perm and that allmade to btain work will bett to do the performed toork and the
meet the standards of all las aws rregulatincated I g construction on in this jurisdiction. This permit becomesonull
and work void
ommenced.not
l understand that separate permits m if
be secuconstructred for Electrical Work,Plumbing,Siion or work is suspended or gns,or aWells�Pools,x uinaces,Boi[months at ers,tHeatetrs,
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 RNEY BEND TFORE RECORDING YOOBTAIN UR NOTICE OF CONSULT H
YOUR LENDER OR AN ATTORNEY
I hereb certify that I chave read and examiomplied with whether t ecihis aedlhertein or not.n and The granting of w the same to be to pea doescno t. plresumetons to of laws author ty tond violatences gor cancel this
e
type q�work will be p
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner "�►' Signature of Co tractor
gn _
Print Name (/ �......................................................'lt
Print Name .. ................................'.........................
�t .. ...pk e.. .......... ..vl< ........ ..lL.e�
Day of
fy�gln�` Befor e 201
Be
L Da of 20 this
this y -
Not P I '�_ JENNIFER WALKER Np JmN WALKS
tom, ; C MY COMMI ION N FF 011480
COMMISSION FF of 11 AK
EXPIRES:AP 24,201 q ed 01.26.10
ril
EXPIRES:April 24,201"1 '?, o�r4 Bonded Thru Notary Public unde
Bonded Thru Notary Public undewr tars
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of Duval
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: �� J -S 2— L� L
Address of property being improved: _� 'R
2 2-
General description of improvements: Re roof
Owner ��3 )l�;�,1 FC i�c 7Zt't kC'
Address Same
Owner's interest in site of the improvement Personal Residence
Fee Simple Titleholder(if other than owner)
Name
aj Address
(�1 Contractor DS Killian Roofing & General Contractors Inc.
I Address 3948 S. Third st Suite 122 Jacksonville Beach F1 32250
Phone No. 904 246 7663 Fax No.904 339 9233
Surety(if any) N/A
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 N/A
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 N/A
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):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: � �'A.�tk'ii. �. DATE
in the