476 sargo 2015 Roof �S r
`S J CITY OF ATLANTIC BEACH
�) 800 SEMINOLE ROAD
'J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
syDIjlM,,
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-139
Job Type: ROOF PERMIT
Description: FL 5444.1
Estimated Value: $5,762.00
Issue Date: 1/20/2015
Expiration Date: 7/19/2015
PROPERTY ADDRESS:
Address: 476 SARGO RD
RE Number: 171543-0000
PROPERTY OWNER:
Name: WIGH III, STEPHEN J
Address: 476 HELMSMAN LN
GENERAL CONTRACTOR INFORMATION:
Name: HOUSE DOCTORS CONSTRUCTION INC
Address: 5782 SAWYER AVE JAMES HOSKINS JR
Phone:
FEES:
BUILDING PERMIT FEE $78.81
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $39.41
STATE DBPR SURCHARGE $2.00
Total Payments: $122.22
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: _g-�(o �
Permit Number:
Legal Description 1Z o o
oor Area o q t Parcel #
Valuation of Work$ S o Proposed Work heated/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proosed structures)(circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): esi enti
es No N/A
Florida Product Approval# of �-
For multiple products use product approva orm
Describe in detail the type of work to be performed: ?—e C) �—
Pronerty Owner Information•
Name:_T Address: �Z (o �,
City (a State LZZip �? Phone �'t`V'i¢ 7 7
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAEL ADDRESS:
Company Name:1Acx05ts- t)oc_ ��vs Y�ty�.► �uali ing Agent: G t
Address: 5782 caw . AV L?
OfficePhone��i- `194-3z,o3 Cita'-- C�sa"`'upp, .� State k A Zip 3ZZod
State Certification/Registration# C CC- C Site/Contact jumber�a9- �q q- 3z,o3 Fax#
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. I certify that no work orihas commenced prior to the
issuance of a permit and that all work well be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void' work is not commenced within six(6)months, or if construction or work is suspended or ttbandoned for a_pertod of six(6)months at anytime after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
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 YO'UR NOTICE OF
COMMENCEMENT.
I hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specs ted 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 construction.
Signature of Owner J�
"''r Signature of Contractor
Print Name = ;. T SOON WILLIAMS
,,... .; m �.1 ............ ..............................
Print Name '�
�...
Before me P= Expires April 23.20 i6 "" - -
•.,Q„ QQ*d Thru Troy Fain trnwrance 800-385-7019 Befo e e
this 10 Day of �,.
thi Day of i>" DORET S
HH dAUMUN VU L2
"t6(Ct", — _ Ekpires Apq 23,2016
tary Public ary Public
Revised 01.26.10
NOITICE OF COMMENCEMENT
State of Roe,(, County of Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that i-tprovements 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.
I.egal Description of property being improved:
Address of property being improved: y 7 G S u 1,Go p
General description of improvements: A,,� r App r'a'n
�2.z33
Owner: ri Np C qc S #eR Address:
Owner's interest in site of the improvement: a
Fee Simple Titleholder(if other than owner):
Name: -
Contractor: y 5 L-,- �c �_ G C Q u A 10 7--V,-3 4z--
Address: lskoa q-e`e-c— A �-�-
Telephone No.: q0 4- c,c(,4'-�-ZAr->3 Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone 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 Floric.. .-ther than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates rhe following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone 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 OWNERDORETHAJACK:ONWILLIAtAS1
���.,__ *� k Couimiss n FE 186
Signed:
�' •o CFEs Z,jRGO
Before me this °'� day o '1` TtPCj I� val -9t- qtr
Doc ii 2015013222,OR BK 17035 Page 23 i 2, Of Florida,has personally appear .��.�Ji
Number Pages:1 Personally Known: or
Recorded 01-20,2015 at 02:23 PM, Produced Identific 'on:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public:
COUNTY My commissio ex ires: ,o"° 'a CKSON INILLIAMS
RECORDING$10.00
Expires',p1'3,2016
•�'%Q ;°`'• Bonded Thru Troy
:an Insurance 800.385J019