1580 W PARK TER 2015 ROOF \j
I ,,SS\ CITY OF ATLANTIC BEACH
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-258
Job Type: ROOF PERMIT
Description: REROOF FL 1956.3
Estimated Value: $9,500.00
Issue Date: 2/3/2015
Expiration Date: 8/2/2015
PROPERTY ADDRESS:
Address: 1580 W PARK TER
RE Number: 171943-0000
PROPERTY OWNER:
Name: PHILLIPS, DAVID B & AMELIA P,
Address: 1580 W PARK TER
FEES:
BUILDING PERMIT FEE $97.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $101.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 6-,q0 Pad -72 rt, IA-Jl<-K Permit Number:
Legal Description Floor Area of Parcel 4 - Tq-Tt—
Valuation of Work$ Proposed Work heated/cooled� non-heated/cooled
Class of Work(circle one): New Addition 6i�g Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial sidentilD
ff an existing structure,is a fire sprinMr system installed? (Circle one): Ye s No <=N/A
Florida Product Approval# ../6 Vz" :3
For multiple products use p" rodticf app-r-o—va-TTo—rm
Describe in detail the type of work to be performed:-ji—it Ma Qe tj/,.4�
121C IPe--A11V14A1J14J1
Property Owner Information:
I A .11;21
Naine:. DA: - 9 P , 'ddress:
city—A Stateg_Zip -
E-Mail or Fax#(Optional _7 Z�Phone �Pf
Contractor Information: CONTRACTOR EMAEL ADDRESS:
V1 _
Company Name: 2.1 nwn Qualif
-a :2z)22- ying-AKnt: 1�n'#e-1 �A Q
Address:rS'S 6 1 city State'�9' Z i p 2=2
f�g Contact Numb
Office Phone 7 Job Site/ er Fax 4
State Certificati�on/kjgistration' #—LLE I f
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 he ebY ade tain a UI d the work and nsta a n a ndca or installation has commencedprior to the
'ic is m erm 0 0 i 'io s s i
3 ,' pi' be e 0 ed to mZt the an ard a,,r thisjurisdiction. This permit becomes null
00
rk
k, s aWeriod of sixj,6)months at any time after
r f rm st � so
m t Or, c ris ct 0 0
6 n
wo w p on 0 tru 'o r I r us
d thin s
t t,P p r i s mu t ,s ur f
0 1 ctrie
p P io r
suance 0 apermi and that a
and Old I work -s not commence w
I u, r,
'o is f "" d de tand a e arate e b ec ed rEe a Ms,Pools, urnaces,Boilers,Heate
,k co e
Tanks andAir Conittioners,etc rs,
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 YOUi NOTICE OF
COMMENCEMENT.
I herelb certify that I have read and examined th lication and know the same to be true and correct. All provisions of laws and F ordinances governing this
"Is
work will be coTplied with whether feci 70 herein or not. The granting of a permit does not presu,;me to give authn 't to violate or cancel the
ions of any th rfj der �y
,gder
,Cder s I ting construction or the peifio�mance ofconstruction.
oq gder la 7toctT4wpua
Signature of Owner X Signature of Contractor
Print Name Print Name
.............
Before me Be e
-11L Dau CIL 20 t'5
v this ay of. 20
Y'. 0E.PIME
a
4
Uy Nnim.Expires Jun 13,2015 R
Commission#EE 89417 My COMMISS10,%, FF 011480
EXPIRES:April 24,2017 evised 01.26.10
Bonded Thru Notary Public underwritsrs
NOTICE OF COMMENCEMENT
State of 14, County of ha-Ijet Tax Folio No.
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 dR-1�4QTICE OFEkD.DAMENCEM
Legal Description of property being improved: I'S b 0 4-r-r �N
Address of property being improved: 'Pk 'rx rtk!z 11,4e6 I &a4
General description of improvements: ('�AIAJ- j�e"
46L
Owner: Address: S
Owner's interest in site of the improvement: 6t
Fee Simple Titleholder(if other than owner):
Name:
Contractor: 3)A-Alf OU 14 AW 12
Add—ress: Lev 4!?,ci I
Telephone No.: Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Doc#2015025093,OR r3K 17053 Page 1898,
Name and address of any person malcing a loan for the construction of the improvements Number Pages:1
Recorded 02iO3/2015 at 10:09 AM,
Name: Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING$10.00
Phone No: Fax No:
Name of person within the State of Florid.�z, )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 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:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
P412 1(o:Z 721,41-0
TMS SPACE FOR RECORDER'S USE ONLY OWNE�.
Signed:V Date:
Beforeihethis -IJA+� dayof----3C,-vv�c-4\r n the County of Duval,State
PEYTON L.PIMENTEL Of Florida,has personally appearedL-�)ckv'i A PS
Personally Known: or
Notary Public-State Of FlOri" Produced Ident fi atiori*
My Comm.Expires Jun 13,2015 c
Notary Public:
Commission#EE 09417
My commission expifes:&T