1970 Francis 2014 Roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Jr ATLANTIC BEACH, FL 32233
ROOF PERMIT INSPECTION PHONE LINE 247-5814
CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMA N:
o - -
Job Type: ROOF PERMIT
Description: REROOF
Estimated Value: $3,700.00
Issue Date: 10/23/2014
Expiration Date: 4/21/2015
PROPERTY ADDRESS:
Address: 1970 FRANCIS AVE
RE Number: 172170-0000
PROPERTY OWNER:
Name: NEWSOME, SHERALLA
Address: 1970 FRANCIS AVE
GENERAL CONTRACTOR INFORMATION:
Name: AQUATITE ROOFING INC
Address: 355 Cottonwood Ln Orange PARK
Phone: 904-813-5214
FEES:
PLAN CHECK FEES $34.25
BUILDING PERMIT FEE $68.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.75
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.
State of j� L 0 2)J 11N County of DU /NL
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: SL 4 C ti tQ R Zf 1 _ ' . 17- as
Address of property being improved: I e(70 E2 A NC 15 (A C E-AC)-1
�Z . 3233
General description of improvements:
Owners�- �a ZL,A N1� U—)5 Q F—
Address FeAAJCIS &JT Eflc- EL 3223
Owner's interest in site of the improvement (-) M r l fh -P 2n J E p1 i
Fee Simple Titleholder(if other than owner) M
Name
Address
Contractor t�Q V A 11 k I- ( QQ,F1"G- 1 10C
Address�5 CQTTUU(.Q0ap n2Mj&E- 400R)�, EL �Z073
P Phone No. qO ' a $- 7 -j`7 Fax No. n(1
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
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 I
different date is specified):
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904) 247-5845
Job Address: ('97 P r E A K C IS 1� q:E . Permit Number:
Legal Descriptions 06: Mh1,JF_R5 RIP 1q�-7-d5 - Parcel# 033(p"i - 00 -7'1$
00 Floor Area of sq.Ft. —Sq. t
Valuation of Work$ 3 704 Proposed Work heated/cooled/_ non-heated/cooled 5 _
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed? (Circle one): es N/A
Florida Product Approval # FL 01 a Z4 - (�
For multiple products use form
Describe in detail the type of work to be performed:Q F_ 20Q'P - j R,- 0 F F E,11- 15 T 1!V G 0200 F
[_o i 14E QECK , NY - ) N (ZQb7 ' g- KL LE
Property Owner Information:
Name: Address: I `7 0 F R R IV C I S 0\ � r—
City A7 L-nN i 1C_ bLRCA State ELZip .23 X33 Phone I Def - 7/(P - 0 q 5(p
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: I)Q U N-f l-Cf- RbQF I PJG INC Qualifying Agent: N OJ\( O N_)G N-T
Address:353 CD(T0JU IUC CD L.-N City OV f} r- Tk RAZ. State F L 'Zip' -73
Office Phone,?O q- a 7fs- `f �Job Site/Contact Numbergl�f- g/3 -Sa I �{ Fax# GIO�{-a7$ - -717 7
State Certification/Registration# C C ( 3 3 OD 3CP
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. 1 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 void if work is not commenced within siz(6)months, or if construction or work is suspended or abandoned for a eriod 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, Healers,
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 certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether speci ed 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 construction or the performance of constriction.
9�Signature of Owner Signature of Contractor V
Print Name ..>T_.. .V ...L1 .. .__......... weJ.h.. Print Name �._��.h/....1............ U.6...i ..................................-.-.
...:..
Sworn to and subscribed before me Swo to and subscri ed Jae ore me
thinDay of .f— 2014 thi Day of 7` 201
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