1350 CAMELIA ST ROOF CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ROOF PERMIT
MUST CALL BY 4PM FOR NE)Cr DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 15-ROOF-1220
Job Type: ROOF PERMIT
Description: FL544.1
Estimated Value: $8,700.00
Issue Date: 5/22/2015
Expiration Date: 11/18/2015
PROPERTY ADDRESS:
Address: 1350 CAMELIA ST
RE Number: 171050-0006
PROPERTY OWNER:
Name: WILLCOX, ALMERITTA
Address: 1350 CAMELIA ST
GENERAL CONTRACrOR INFORMATION:
Name: HOUSE DOCTORS CONSTRUCTION INC
Address: 5782SAWYERAVE JAMESHOSKINSJR
Phone:
FEES:
STATE DCA SURC14ARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $93.50
Total Payments: $97.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PFRWHINUM13ER
NOUCE OF COMMWCEMIENT
FLORR)AL STATUTE 713.13
SrATE OF FLORIDA
COTJN7Y OF CLSY
The undertiqlamed.hereby wes notice that impacripmement will be made to cartam real property,
and in accordance with Chapter 713, Florida Statutes, the folloning inf,,,mati.is provided in
the Notice of Commencement
1. Description of property:(legal dmIxYCnPuTf the P!Opr,aiI address if availab
l-mv A-A r,� (" 72 S7
2. (jeneral description of imp
3. 0synerInformation:
a- Name and address:jtl rr)6r tA Lw/ ") �c 0 ,�
1 :?>50 -il`-Vee-, 11 14,( Rea, V\
b. supumntirmpropmerly: mmi — ,,A
tm� ti,
Name and address or fas,simple muncroar(nothe,thm,,,or):
4. Corr�or�mef-d�
,c �7)1 A—
Ayt�- TI
&Phone number Fictimardamen
5. Surety.
a, Name and address: z
b. rhone number. c. Faxtumber:.
& Amount of bond:—$ ,�
6. Lertder:(Name and Address)
& Phone number. It. Faxnumber:
7. Persons Withia the State of Florida desigard by Orstrour upon whom noticas or other docuntents
may be served aa provided in Section 713.13(lXa) 7., Florida Statutes: (name and address)
a.Phone number.. b.F�number.
In addition to him If�O�r dw�iguates
Of —to receive a copy of the Lierpoes Notice as provided
to Section 713.13(l)(b),Florida Statutes.
9. Expiration date of notice of corturneocammt (the expiration date is me (1)year from the date of
recording unlymuss,.diff immitildste,;.
Doo AIM1511�11,ORBK17175 Pagm,1064,
Numloer Pages I
Risoomok"J0512Z201591048AM.
Ronnie Fu It CLERK CIRCUIT COURT DUVAL S, of Clipstuar
COUN�Aes ="-,Fr.
RECORDINGsia.w Print Name
sss,curn to (or aftinned) and subscribed before me this 2_1 4 day of
M4 20�1 by
a e 0 e
CHILS1,A A MACKIE
Nolartil'imbli, SlaeolFlorrida
Sesj My Comm Expires Jul mi.21,
Signature f Notary-State of Florida
Commission#EE 111413
BArdep rumuir,Wannal Noury Assn
Personally Knompun_OR Produoad IdentificationlType
BUELDING PERMIT APPLICATION
CITY OF ATLANTIC REACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
JobAddress:
_a Permit Number.
Legal Description 1 4 Z:� Pam]
Valuation of Work S ed Work ,�ent I ed/cooled
P�700, .1,701"'s — non-heated/cooled
Class of Work(circle one): New Addition Alteurstion (Kpa�w) Move Demolition pool/spa window/docir
Use Of existing/proposed structure(s) irele one): Commercial Residential
If an existing structure,is a fin spritWer system instatted?(Circle one): Yes No N/A
Florida Product A proval#
For multiple pr2octs on p
Describe in detail the type of work to be performed: --p
Property O*ner Information:
Nama � I MW;ta W il� 0,6 X Address: I C::>
City A'R spi(- ellic Staft ELZip 19?-�Phons, I 2,-u- ,j I
E-Mail or Fax#(Optional)
Contractor Information: CMIR A�-TM EAWL A DDR E S 8-
Company Name;qtx�- D"L,. La, YAarQuali ngAZ�. fKW C'�' f—
it
I
Address: U city pu� t Stne� ink EP
Office Ph .VLL)V�rr- zi
-3ZO3 Job Site/Contact Number 'To+ as#
--31 Fite a
NtateCertification/Registmtion#---&!!�,�/ ?-&CLZ � F
ArobitectName&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder e and Address
Bonding Company Name and Address
Mortgage Leader Name and Address
Apalietiffeas is hereby made to obtain operant to do the work and installations as inshouted leer*that no work or installation bes,commancedprier to th,
i surnance%apermir and that all work will brise'roemuday meet the standarair ofatl laws rsitylat'veonensuct, nindusprisdictles, Thapprealbyr I
ey
undyed yorkisn-flearommeniaoithintrueffi, tramers,
w ffnaled
TLk wed l�derstandihalsepamie�vrmi6m�tbewcumdf�Ekad Work, orabauupaVorVrriodof'mZ)months at�-c.-
v Z�..7e,
W&A-1,Conatfidoneye,da piambireiry Als, efispoed., sure,
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 WITII
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUi NOTICE OF
COMMENCEMENT.
I hare�certifythatlhme readandisoaminedihij)FUcation and knew thesernew to be true and,orre,t. Allprm4i
I will be com n
plied with wheethersat dhommay,not. Me grossing ol'a permit does nolpresiseite"an"94'Tthard h
�rtturyyliaxgou,
= yx
the
Signature of Owner&Lk�(�- Signature of Contract,, a., /M" J�Z,
Print Name -Z�.4
............ Print Name
Befo Be e
jLTF] 20 thl Da of
Day f
A MACKIE
Notary Public I y L Gran
2015 My F 0869%
My Comm Expires Jul
Corrrmssiofl;FEEI' �13 C.immes.ri
413
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