310 Camelia St 2015 Roof CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
�} ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-145
Job Type: ROOF PERMIT
Description: reroof f1101234.1
Estimated Value: $4,500.00
Issue Date: 1/21/2015
Expiration Date: 7/20/2015
PROPERTY ADDRESS:
Address: 310 CAMELIA ST
RE Number: 170876-1000
PROPERTY OWNER:
Name: HURLEY, DANIEL
Address: 310 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: CARBON COPY CONST, INC. (ROOF)
Address: 12412 SAN JOSE BLVD APT 301 QA LEONARD ABRAHAM
SCHONFELD
Phone: - -
FEES:
BUILDING PERMIT FEE $72.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $76.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
3333
Job Address: 1 C 1 �R ��,�A 57 art-Vic(^ Permit Number:
5�C � 4=(� A/-(t t�i`1(�it
Legal Description S- - 1 ; ?A v J, arcel# t
oor ea o • t• -Sq
.Ft
of Work$ 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/propposed structure(s)((circle one): Commercial Residential
If an existing strut}ure,><s a fire sprinider system nstalled? (Circle one): Yes No N/A
i
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: c 5
Property Owner Information: /
Name: I�AtJ t E L �� 2` 4 Address: 071 (
3 `X
City 0 L SCI-1 Stated Zip}Phone
E-Mail or Fax#(Optional)
Contractor Information: (
thXgent:
Company Name: f) 6 r. _PC- Qualifying AState
�l�ttio/ S��S'pr
-� 31 CityAddress: IAV\a- SAN � D ContactNumber ` 1�SFax# 03
Office Phone 0-J3 Job Site/
State Certification/Registration# GCC
Architect Name&Phone# AJ 14
Engineer's Name&Phone# /1
Fee Simple Title Holder Name and Adt4A
Bonding Company Name and Address
Mortgage Lender Name and Address
that no work or
is
suance onQpermita that al work w bemade to obtain a lt to do the prior to the
erformed toomeet the sta rk and installations
of alllaws regulatinicated. I g construction in this urisdic ion.months at a Th s permit becommenced pcomes n
ull
and void f work is not commenced within six(6)months, or if construction or work s suspeW d or ,Sdfns,° �poolsofs,X u)rnaces,Boilers,Heaters,
work s commenced. 1 understand that separate permits must be secured for Eleelricaall g, g
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR O OBTAIN FINANCING, CONSG TWICE FOR ULWITH
MENTS
TO YOUR PROPERTY" IF YOU INT
YOUR LENDER OR AN ATTORNEY BEFORENCEMENTE
RECORDING YOUR NOTICE OF
C
his
1 here certify
that c�pl ed and whetexamined the icats
or and know
he granting of a per dcesthe same to be true and cnot prt. All esumetogons ive l thoaws rity to violatences gor cancel
type,1. her pe
provtslons of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contrac
. .... y_ 1 .. r
` ! .. .!/-
. ..................
............Print Name ...: _
......Print Name _..........
_ _.
Sworn to and subscribedbefore me _ Swthisorn to andsuubscr subscribe before me
of U
this a Da MARK 691 ROVER
MARK bRUGE BOYER P,, State of Floris
•i PRv rGUb���,• Public-State of Florida •`,> a•., blit
2015 .°: Expires o
' * ?My Comm.Expires Nov Notary ub lc '_: =MY comm. EE 119104
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commission# "`` Cq� '
• = National Notary
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Doc # 2015012889, OR BK 17038 Page 1437, Number Pages: 1, Recorded
01/20/2015 at 11:52 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of Florida County of Duval
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved:The south 1/2 of Lot 5 and all of Lot 6,Block 108,Section H,Atlantic Beach
Address of property being improved: 310 Camelia St. Atlantic Beach FL,32233
General description of improvements. Re-roof
Owner Daniel Hurley _
Address 310 Camelia St. Atlantic Beach FL,32233
Owner's interest in site of the improvement Res.
Fee Simple Titleholder(if other than owner) N/A _
Name
Address —
Contractor Carbon Copy Construction Inc. Leonard Schonfeld
Address 12412 San Jose Blvd Ste 301 Jacksonville,FL 32223
Phone No.
Bao-2183 Fax No. 880-2185
Surety(if any) N/A
Address Amount of bond$
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): 3/1/15
THIS SPACE FOR RECORDER'S USE ONLY OWNE
Signed
DATE/S—
Before.. --TA,4&r In the
County of Duval.State of Florida,has personally appeared herein b
t(— Y
' himself/herself and aeirms that a I statements and declarations herein
are true and acture A
LEO OM ICII#PF%
. EXPIRE1,8 Am r 1051821
EXPIRES. yPi W
7,2011
eue.e n.0 ran'
tary ul at Large,State of r . County of
My commi ion expires: —
Personally own V_ or
Produced Identification —