253 Seminole Rd 2014 Roof i�j►„1r`��jf3
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001450 Date 9/03/14
Property Address . . . . . . 253 SEMINOLE RD
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2600
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Application desc
Remove and Replace Shingle Roof
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Owner Contractor
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VITTITOE, JEFFREY H JUSTIN LARSEN CONSTRUCTION INC
253 SEMINOLE RD PO BOX 1942
ATLANTIC BEACH FL 32233 4784 CATTAIL ST
MIDDLEBURG FL 32068
(904) 241-0320
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Permit ROOF PERMIT
Additional desc REPLACE SHINGLE ROOF
Permit Fee . . . . 65 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 2600
Expiration Date . . 3/02/15
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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 65 . 00 65 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
alit)ItA.1IIVIr 1 1"KIVll 1 /\1'1'l,ll.;\ 1 MN
CI'I'Y OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach. FI. 32233
Office (904) 247-5826 Fax (904) 247-5845
.lob Address: �-3 -5ei-1,koo Permit Number:
Legal Description /O-6 16 Parcel 9
� —
_ oor Area of— Sq.t. c.'t
Valuation of Work 5���. Proposed Work heated/cooled non-heated/cooled I-3
10
Class of Work(circle one): New Addition Alteration (n> Move Demolition pool/spa window/door
s
Use of existing/proposed structure(s) (circle one): Commercial ;idcnti,
If an existing structure, is a fi sprinkler systen installed? (Circle one): s No N /A
Florida Product Approval # 6 •
For multiple products use product approval ori
Describe in detail the type of work to be perlormed:_ t:^
Property Owner Information:
Name: 1 1 �^�'K.. Address: , �T
City State Zip Phone rs
E-Mail or Fax # (Optional)
Contractor Information:
Company Na! e: , ,
'v� a-4 � �c iy` .Gig 1
p y � _ _ --Qualifying,A �•n J�r�
Address: G ,�' _ City 4;1, Zip
Office Phone 0/- - I& Job Site/Con act Number - - Fax# y -wj
State Certification/Registration # Lam( J_7�%yy�
Architect Name& Phone #
Engineer's Name& Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address fT
Mortgage Lender Name and Address
Ipplicalion is herehv made!«ohluin u permit to do the work cute!installations«s indicated /certiyv thul no work or installation has commenced prior to the
issuance of a pennii and Ileal all a ark gill he pe rf rr•nrecl io meel the standards of till/encs i-egttlalini!constructor(in this jrrricdiclion. Thls per•nrii becomes rill
and vuir/if work is not c unuuerued within six(6)months, or if c unsh urtiun or work is suspended ur abandoned%ur cr period o/'six(G)uwnllrc at ani,time a%Mr
work is eununenced. 1 urulerslcurd that sepurcrle permits mull hr secvued fin Electrical Werk, Plumbing,Signs, 11i1/s, Ptiols, Furnaces, Boiler's, //eaten,
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 hereby certif i,that/have reud and examined this cpplication and know the.carne to be tette and c•orreel. :Ill provisions of hru•s and ordinances gover•rring this
ttpe of work hill he complied with whether specrfred herein or tial. The granting ol'a per•mil does not presume to give cruthoriti,to violate- or cancel the
provisions t f ani,other t c erul,stale. or local law regulaliw construction or the perfornurrrc•e of construction.
Signature of Owne -- 7ttS�� -- _--- Signature of Contractor
Print Name Print Name
" -
4*0
Sworn to and subscribed before me Sworn to and subscribed before me
this;1— Day of M r� this — Day of_ �6tG_ 20,0",WI—� ' PVIgLLIAM L POPE
Nota[Ylti�t Shte of f�lorida
Notan Public My coExoriso�ct.19,20i5 Notary Public
����-NhleW �- .
mm. y209b
Commission No.EE 118745 My Ct��e Y" (
Rexti:�'d1fW.26° #wi45
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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: 1c"U
Address of property being improved: 'ca�0 h ROA- -14 1/
tq —TL-
General description of improvements:
Owner t 4OL.
Address I e— CL 2 w
Owner's interest in site of the improvement �!-J,zaj
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor Le-est-A,%
9
Address 0
Phone No. �bq- 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 Lienor's Notice as provided in
Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option).
Name A
Address MA
Phone No. Fax No.
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a