1993 Colina Ct 2015 Roof CITY OF ATLANTIC BEACH
S�
800 SEMINOLE ROAD
J 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-122
Job Type: ROOF PERMIT
Description: FL10674 R7
Estimated Value: $4,460.00
Issue Date: 1/15/2015
Expiration Date: 7/14/2015
PROPERTY ADDRESS: —
Address: 1993 COLINA CT
RE Number: 169506-1066
GENERAL CONTRACTOR INFORMATION:
Name: PRIME ROOF CONTRACTING LLC
Address: 13792 HERONS LANDING WAY APT 9 QA MARK ANDREW
YOUNG
Phone: - -
FEES: —
BUILDING PERMIT FEE $72.30
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $76.30
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MEMNON
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1993 Colina CtAtlantic Beach,FL32233 Permit Number:
Legal Description 39-94 09-2S-29E SELVA NORTE UNIT ONE Parcel#
Valuation of Work$4,460 Proposed Work heated/cooled 3237 non heated/cooled630
Class of Work(circle one): New Addition t, pair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): ommercial esldenti
Ira existing structure,is a fire sprinlrler system installed?(Circle one):
Florida Product Approval# FL10674-R7
For multiple products use product approve orm
Single Family Home Repair.Tear off shallow section in back and
Describe in detail the type of work to be performed:replace wood,reshingle.
Property Owner Information:
Name:Susan King Address:1993 Colina Ct
City Atlantic Beach State FL Zip 32233 Phone 904 868-6957
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Prime Roof Contracbnq Qualifying Agent:
Address:372 Royal Palms Dr City Atlantic Beach State FL Zip 32233
Office Phone (%4)4w-8aw Job Site/Contact Number(904)625-1446 Fax#
State Certification/Registration# CCC1329505
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. 7 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 swards ofall laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction�r work is suspended or abandoned for a period of sir/6)months at any time after
work is commenced l understand that separate permits must be secured or Electrical War*,Plumbing,Signs,Wells,Pao&,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 YOUR NOTICE OF
COMMENCEMENT.
I hereb certify that l have read and examined this plication and bow the same to be true and correct.All provisions of laws and ordinances governing this
type of work will be complied with whet er speci�d herein or nota a granting of a permit does not presume to grve authority to violate or can
the
provisions of any otherfederal,state,o l law regulating cons on or the performance ofconstruction.
Signature of Owne Signature of Con tor„
Print Name SAn A. Izenr Print Name
Swom,tjq and subscribed before me Sworn to and subscribed before me
this ay of /� 20 this t ay f 20
Is
Notary ruDi1c Notary�ibfi �iN o �'—",�
Revised 01.26 10
Andrew D. Davis
ES:W 17,ON IF 20 8 � �y, Andrew D. Davi
*"JUN01010TOY-M 0MON It FF1M9
_. EXPIpE��S..:ww^^S17, 2018
21. full ''e,puutMM
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: 39-94 09-2S-29E
SELVA NORTE UNIT ONE
Address of property being improved: 1993 Colina Ct Atlantic Bea"h FL 32233
General description of improvements: Re—roof
Owner Susan King
Address 1993 Colina Ct Atlantic Beach FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Prime Roof contracting, INC.
Address PO Box 50247 Jacksonville Beach, FL 32240
Phone No. 904-452-8440 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
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'S USE ONLY R
Signed:4�T
DATE � vinue
Before ay of n
County Florida,has perso ally appeared
S1fSA 1Cj,A herein by
himself/herself and affirms ftlat all statements and dedarations herein
Doc#201501098r,OR BK 17036 Page 170, are true and accuratef�y/ Andra�1p��
D. N*Number Pages: 1 �/
Recorded 01 1512015 at 02:25 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL ` =4e �►_ COWMON f FF16W9
COUNTY % • Effln W 17, Me
RECORDING$10.00 Notary Public at T arge,State ofA.e�Nrft R�=
My commission expires: 4 X1.01 f BI .evYl V, eVw
Personally Known r or
Produced Idents icatlon d �'�N�',C