760 AMBERJACK LN ROOF S�-1,Jr7D
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-933
Job Type: ROOF PERMIT
Description: reroof 15444 r-2
Estimated Value: $4,498.00
Issue Date: 4/22/2015
Expiration Date: 10/19/2015
PROPERTY ADDRESS:
Address: 760 AMBERJACK LN
RE Number: 171130-0000
PROPERTY OWNER:
Name: PAINTER, KEVIN,
Address: 760 AMBERJACK LN
GENERAL CONTRACTOR INFORMATION:
Name: NESTER'S ROOFING AND COATING INC
Address: 210 Mimosa Rd ST
Phone: -
FEES:
BUILDING PERMIT FEE $72.49
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $76.49
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
800 Seminole Road,Atlantic Beach,FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: 760 Amberriack Lane Atlantic Beach FL _"/�
Legal Description -(p -25 -29E / cyY�fSanl- / Parcel# / /J3o"6w
oor a y q. L Sit. t
Valuation of Work$/ YqY,&�3 Proposed Wor heated/cooled -heateyUcooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/propused structures) circle one): Commercial
If an existing structure,is a fire Spina system installed?(Circle ooe): o estialN/A
Florida Product Approval#F-4 544 —PL7
For multiple products use product approval tom
Describe in detail the type of work to be performed; Ai(1Q I f rC -61J.
Pronerty,Owner Information:
Name: Wirt Q ( Address: 769 /1/nfXri�i� Lone
CitySmtaCl Zip 3223 33 Phone
E-Mail or Fax#(Optional)
Contractor Intormatioin: / 1/ "7` U
Comoanv Name: Qualifying Agent: n` Y. / r 1SI(l
Addres ��' /ALSO Ci t e7t State C Zip =086
Office Phone 90/ Jsz S'S6S Job SiteJC pct Number -Gf .2 2. Fax#90V-e7/2-oo7d
Slate Certification/Registration# CCC
132 90 fl
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 apermit to da the work and instnllatiorsr ar indicated 1 renJy Mat no work w Instillation has cammenred prior to the
vent.In road and that all work willbe%lorm
ed to meet the standards ofall laws regulates,construction in Chirjarbdiction They;,emit becomes null
and void iJ work u not mmmu
eedwiMin six(bJmorttlu.w ifconstrucllan or work is
nt cM �d w abardanedfw a aoFfx hnmorNhsma ,Hf
workiscommenced 1understadMasepwa(epermimmuberedforE/MtiWork,Rumbin8Signs, Wfcex esr,
Tanks andAlr Conditioners,me
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 YOM NOTICE OF
COMMENCEMENT.
I henby certo /an I hme read and ewmined this appfication..dknowthesametobetrueatdcwrect AI(pmvaimvoflawsardardinmuesgaverningthu
type.%work will be complied with whelber s c/ d herein w nm. The granting,ea permit does not presume la gree y Ritylfolate or carrel the
pravmny oru ofaother feder�all..)state,adoral law
__._...... R_ .uda ng.leato,".._efi_onote peforos.of oushuclon.
SignatureofOwner SignatreofContrsct
or C�
Print Name
Print Name _ _✓.............:.....—!_.�1 _._.._..�
Swore to and subs?❑bed before me Swom to and subscribed before me
this 2L Day of IYrril .2015 this ,W ay of An4iL .2015
'4499
Notary Public Notary Pu It,
Nmatr Puaicstatn?1Wftd .26.10
SUSAN CURRIE Dayne H W1Bams
p My Comm6fbn EEt 196]5
yAy1 i MY COMMISSION NFF133470 ym Ergin oNa)rzo15
�kq EXPIRES dune 17,2018
(eon xeatss rbnaeNdWservb.mm
NOTICE OF COMMENCEMENT
State of Florida Tax Folio No. 171130-0000
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 ofproperty being improved: 30-60 38-2S-29E ROYAL PALMS UNIT 1
03120 ROYAL PALMS UNIT 01
Address ofproperty being improved: AMBERJACK LANE
Generaldescriptiono£improvements: SHINGLERE-ROOF
Owner: KEVIN PAINTER Address: 760 Al BERJACK LANE
Owner'sinterestinsiteoftheimprovemene OWNER
IeA
Fee Simple Titleholder(if other than owner):
Name:
Contractor: NESTER'S ROOFING AND COATING INC.IKELLY HESTER
Address: 210 MIMOSA ROAD ST.AUGUSTINE,FL 32086
Telephone No.: 904-315-5565 Fax No: 904-212-0030
Surety(if any)
Address: Amount of Bond S
Telephone No: In No:
Name and address of any person making a loan for the construction of the Doc M 2015090311,OR BK 17139 Paget 019,
Number Pages:1
Name: Recorded"212015 at 03:56 PM.
Address: Ronne Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
Phone No: Fax No:_ RECORDING$10.00
Name of person within the State of Florida,other than himself,designate,
smed: 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)(6),Florida Statues. (Fill in at Owner's option)
Nam:
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):
THIS SPACE FOR RECORDER'S USE ONLY OWNER //—
Signed: IeaO L� Date" y Zl o;
Beforemethis ZI dayofrl AOA in the Cowltyoftiuval,Sore
Of Florida,has personally appeared It.,q1 VF ^-ker
✓" "� SUSAN CURRIE Notary Public at Large,State ofFlodda,Coumy ofWvel.
r MY DDMMI$$IDN IFF13aQo
Myr (0ti�i+Jl! or
EXPIRES June 17,20te Prrooducceed Identification:FL D i- 53bSC4 b 04270
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