1619 Beach Ave 2014 Roof CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
ROOF PERMIT INSPECTION PHONE LINE 247-5814
-5814
CALL BY 4PM FOR NEXT DAY INSPECTION: 247
JOB INFORMATION:
Job ID: 14-ROOF-344
Job Type: ROOF PERMIT
Description: REROOF FL 5444.7
Estimated Value: $17,840.00
Issue Date: 11/12/2014
Expiration Date: 5/11/2015
PROPERTY ADDRESS:
Address: 1619 BEACH AVE
RE Number: 169648-0000
PROPERTY OWNER:
Name: MOODY, DOUGLAS W
Address: 1619 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: JACK C. WILSON ROOFING CO. OLD KERTIS VOSS
Address: 4522 ST AUGUSTINE RD QA HAR
Phone:
FEES:
BUILDING PERMIT FEE $139.20
STATE DCA SURCHARGE $2.09
STATE DBPR SURCHARGE $2.09
PLAN CHECK FEES $69.60
Total Payments: $212.98
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
JobAddress: PermitNumber:
Legal Description Parcel#
Yloor Area bt Sq.Ft. Sq.FT—
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition(Allteratio)Z) Repair Move Demolition pool/spa window/door
rn
Use of existing/proposed structure(s)(circle one): ommercial eside
s
If an existing structure,is a fire spHnlkdler em installed?(Circle one): es No
Florida Product Approval# SLk 6�)
For multiple products use product approval lorm
Describe in detail the type of work to be performed: �-ucc�c�
Property Owner Information:
Namej-_ 6� -Address: k��
city �nc . Y:2L�statej��ip ZA Phone !)bq -
E-Mail or Fax#(Optional)
Contractor Information:
Company NameA"LA lksuN Qual gA e
Address: I . Ci I ifym�_ —State X7A I- Zip
�6 k�,A G��Contact Number _�Ak
Off ice Phone !C��,L-4L4J (v LCA 6 Job Site/ C ax# R04- -�AL, -A-100
State Certification/Registration# Q-1f, T-)L6-vz;�4
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A a e ada ain �do ork a alla or installation has commenced �e
io as prior to' 11
thisjurisdiction. This permit becomes n
a i d �l f er
r�, o s" n a,,qn� ea
t rs,
mo tifle e'
to Z 0 m7 ta V 2r4�
Oro d t �t! c on r er 11 Po
's mom , or I c
o't a rmi
-5 �a' �r .t a t t all work wi"
P" 0
p
uance k m not co d w Lthin U�(6 it 0 cure If S
s 0 p ber� dyor El e S,Purnaces�Bo let
and vo,'d
or jdws� 3�r e per,�s must
c
0 k s enced u r t t t , a
Tanks andArr Con . one ,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
rff,�NJQ& �, T IN YOUR PAYING TWICE FOR IMPROVEMENTS
UU1K YO INTEND TO OBTAIN FIN ONSIJLI WITH
ATTORNEY BEFORE RECORD
L%
- I
MV Comm.Expim Doc 3.2017
COMMENCEMENT. MWY Public-Still of Florida
commission#FF 044467
MY Com.Exploss Oft 3.2017
I ho i3pplication and know the same to be true and correct. AIH awspomimmesevisatwomp st4win is
r MRAM I r h
r e-qj
11
type oj WoFic will-De Tom tea herein or not. The granting of a permit does not pnr u iw"ifa vanrp the
_p7ma 011—MINW7! V i
provisions ofany otherfederal,state,or local law regulating construction or the peif;o�mance ofconstruction.
Signature of Owner Signature of Contractor
Print Name Print Name ........... .......................................................
Sworn to and subscri SwomAQ-and subscribped�e re me
of Vdre,;e
this �_Day Z .201V this _��ay of .20
E__ Z�z 4
Notary Public Cl/ Notary Public L__
Revised 01.26.10
Doc # 2014248679, OR BK 16964 Page 231, Number Pages: 1, Recorded 10/31/2014
at 03:10 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
iPREPARE IN DUPLICATE)
Permit No. Tax Folio No. V�
State of TA,-\u County of
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with Section 7113 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved
-�-Ck "A
Address of property being improvedi
General description of improvements:
Owner nwd,�
Address �"I 17A —KC-Lc� M g—
Owner's interest in site of the improvement C) C.,
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor JACK C-WILSON ROI)FIL11
Address 4522 St Afjomfinp Rd
Phone No. Jacksonville,FL 32MNo.
Surety(if any) (904)396-1546
Phone No. Fax No,
Address Amount of bond$
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�
Narne
Address
Phone No. Fax No. r
0
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),Flonda 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):
THIS SPACE FOR RECORDER'$USE ONLY NER
Sl DATE
Before"thir W
County of Duval. I. I Florl —nby
hnseo,herieffarici arl thilrif3stal.rhents and 4eciani herein
am true nd accudi ze
Notary Public W of--;,
my cornminion expirel I-41
P"""'Ity Known —or
Produced dertmeabon