202 PINE ST METAL ROOF 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-536
Job Type: ROOF PERMIT
Description: metal roof
Estimated Value: $7,820.00
Issue Date: 3/10/2015
Expiration Date: 9/6/2015
PROPERTY ADDRESS:
Address: 202 PINE ST
RE Number: 170558-0000
PROPERTY OWNER:
Name: STANG, KAREN KLEE
Address: 202 PINE ST
GENERAL CONTRACTOR INFORMATION:
Name: HAGERTY CONSTR. AND ROOFING
Address: 3749 QUINBY ISLAND CT QA QUIN K HAGERTY
Phone: - -
FEES:
BUILDING PERMIT FEE $89.10
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $93.10
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. 170558 - 0000
State of FLORIDA County of DUVAL
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: Lot #55255, Section #3, Saltair
Address of property being improved: 202 Pine Street, Atlantic Beach, Florida, 32233
General description of improvements: new Standing seal'1't metal roof
Owner Jackie Obanion
Address 202 Pine Street,Atlantic Beach, Florida, 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Hagerty Construction&Roofing,Inc.
Address 12850 Winthrop Cove Drive,Jacksonville,Florida,32224
Phone No. 1-904-992-9960 Fax No. 1-904-992-9961
Surety(if any)
Address Amount of bond$
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.
h
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a 2
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY -OWNER _ o
Sig
Cl
DATE'�� (� C2
Before m this day of the N
County uval. ate of Florida.has persona appeared
Doc#_i;15054331,OR BK 1709'1 Page 1344, JACK OBANIC herein by z 2 W
Number Pages: 1 himself'herself and affirms that all statements and declarations herein � 2 %
Recorded 03 10/2015 at 10:52 AM, are true and accurate
U.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY ('
RECORDING 510.00
Notary F*blij at Large, of FLORIDA County of DuVAL
My comrAission expires:
.^
Personally Kno,;:n or ,���� •• �
Produced Identification FLORIDA DRIVERS LICENSE
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: '702 ?I me U—kQ;.r Permit Number: —
Legal Description W' CZS-S *3 Parcel# 14-1) K-7k�4P, , 006
Floor Area ot Sq.Ft. t
Valuation of Work$ 7,0,00 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/proosed structures)(circle one): Commercial Reside
If an existing structure,is a fire sprinkler system installed?(Circle one . es o N/A
Florida Product Approval# t? , -I-
For
For multiple products use product approval form
Describe in detail the type of work to be performed: jZA�-1`1D\bt4, lE ti-x I S 134 G 14ALX
S4(AALa 2WE - 1 11UL NEI.) SID/IW )HAIL SYS L
Property Owner Information:
Name:ck kl^ts Address:ZbZ ( ! S —
City A=rk h3TlC, � State rZip�ZZ,�3 Phone 1g � 1) S 3
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:}b4.�IM /n►. Lf MpgI j 1 rtL• Qualifying Agent: /�yj l ysl 017ti Jllat,-Z `(
Address: city State rA- Zi L ZZ
Office Phone Job Site/Contact Numbe limit- /j1_ Fax# �mt . ctq l • (o l
State Certification/Registmtion# CCL OT-=4IC —
Architect Name&Phone# hAI& —
Engineer's Name&Phone# NIA —
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 Phe
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 16)months at any time aJ ter
work is commenced. I understand that separate permits must be secured for Electrics!Work,Plumbing,Signs, Wells,Pools, t'urnaces,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 hereb certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing U his
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to iv authority to violate or cancel t the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Con c o
Signature of Own � \ —
Print Name t:�....._( 111.�. Print Name ( .><K�........ . .......... . ....'�
Sworn to and subscribed before me Sworn to and subscribed be ore me .20 .'
this I Day of WUM .20 /� this -4-Day of d(
Notary Public Notary
=A2
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ER TIFFANY OARDNER
M9875 •'= MY COMMISSK � •10
16 EXPIRES August 06.2016
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