472 Skate Rd 2015 Roof `SCITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-120
Job Type: ROOF PERMIT
Description: FL 2533 R-12
Estimated Value: $5,000.00
Issue Date: 1/15/2015
Expiration Date: 7/14/2015
PROPERTY ADDRESS:
Address: 472 SKATE RD
RE Number: 171565-0000
PROPERTY OWNER:
Name: TETEN, RALPH M
Address: 472 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: VQUEST CONSTRUCTION SERVICES INC
Address: 4126 Leward PT
Phone: - -
FEES:
BUILDING PERMIT FEE $75.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 472 Skate Rd Atlantic Beach, FL 32233
Legal Description 31-16-38-2S-29E Parcel# lot 22 blk 19
Floor Area of Sq.Ft. Sq.Pt
Valuation of Work$ 5000 Proposed Work heated/cooled 800 non-heated/cooled 1200
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval #FL2533-R-12
For multiple products use product approval form
Describe in detail the type of work to be performed: Tear off and reroof modified bitjon flat roof
'lop
Vol
Property Owner Information:
Name: Ralph and Naomi Teten
City Atlantic Beach State FL Zip 32233 Phone
E-Mail or Fax#(Optional)
Contractor Information
Company Name: VQuest Construction Services, Inc. Qualifying Agent: S. Kevin Clement
Address: 4126 Leeward Point City Jacksonville State FL Zip 32225
Office Phone 904-334-1832 Job Site/Contact Number Fax#
State Certification/Registration# CCC 1326034
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 or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of al[laws regulating construction in this jurisdiction. This permit becomes null
and void of work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Wark, 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 YOUR NOTICE OF
COMMENCEMENT.
1 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 o work will be complied with wheth r s ecr 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 1 aw regul ing construction or the performance of construction.
blyiA O w n Or
Signature of Owjw- gnature of Co or
Print NamePrint Name r rt . �j(Y1, — . .
...........t................ .. ...... ....-� �............. .........................
Swo an ubscr a ore ,,,� ribedbe r in
is ay of
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Shirley Graha
v My Commission FF La
'T 02/14/2001
lc x�IS�� �r��4I®11 ised 01.26.10
NOTICE OF COMMENCEMENT
State of
Tax Folio No.
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 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: 31-16 38-2S-29E R/P PT of Royal Palms Unit 2A Lot 22 Blk 19
Address of property being improved: 472 Skate Rd Atlantic Beach,32233
General description of improvements: Reroof
Owner: Naomi Teten Address:_472 Skate Rd Atlantic Beach FL32233_
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other t7Z,
:
Name: r S . C a
Contractor: VQuest Construction Services Inc
Address:_4126 Leeward Point Jacksonville,FL 32225=
Telephone No.: 904-334-1832 Fax No:
Surety(if any) _
Address' Amnnrnt of Rmid C
Telephone No: Fax No: Doc#2015010826,OR EIK 17035 Page 2114,
Name and address of an g — Number Pages 1
y person making a loan for the construction of th( Recorded 01 15 2015 at 01:07 PM.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
Name: COUNTY
Address: RECORDING$10.00
Phone No: -
Fax No;
Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
P (1)year from the date of recording unless a ditTerent date is
Expiration date of Notice of Commencement(the expiration date is one 1
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed:
Date- x-15- Ir,J-
Before me this L day of �_n_ri.� r . in the County of Duval,State
Of Florida,has personally appeared_R� ���Q
o�'"�°6s;;•, KATHY 8 GRANFORS
Notary Public at L
Notary Public•State of Florida arge,State of Florida,County of Duval.
Fav Comm.Expires Nov 20,2018 My commission expires: LI-2l�-►$
Personally Known: or
.;,�����;••' Commission #F FF 174929 Prod ed Identificati _t=L,%)L T Cotter- 1l0-LDikS- O