395 POINSETTIA CT ROOF CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
jJ�9
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-1306
Job Type: ROOF PERMIT
Description: ROOF FL 10124-R8
Estimated Value: $12,500.00
Issue Date: 6/3/2015
_ Expiration Date: 11/30/2015
PROPERTY ADDRESS:
Address: 395 POINSETTIA CT
RE Number: 170476-0000
PROPERTY OWNER:
Name: Edwards, Sandi
Address: 395 POINSETTIA ST
GENERAL CONTRACTOR INFORMATION:
Name: ROOF IT RIGHT LLC
Address: 2175 KINGSLEY AVE SUITE 207 QA BRIAN J. CAMERON
Phone: - -
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $112.50
Total Payments: $116.50
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of F e d-"- Countyof 7�t
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain mat property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT. � n
Legal description of property being improved: [/)',
Address of property being improved:.?•CS 7�(r�4S 1R��. U1' Alf 9-11,1/
General description of improvements: `Vii �
Owner
Address AIAU—i, cls —
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor t
Address��7 /�
Phone No. - /�/ Fax No. �11i0�F
Surety(if any)
Address Amount of bo d$
Phon o. Fax No.
Name and addre of any person making a loan for the construction of the 1 rovements.
Name
Address
Phone No. F No.
Name of person within the State of Flon other th imself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. F o.
In addition to himself, own esignates the following person to recei copy of the Lienol's Notice as provided in
Section 713.06(2)(b) orida Statutes.(Fill in at Owner's option).
Name
Address
P a 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 ONLYg R
4
DATE /
Before me this day of In
--_ Coun Duval, to of�ba,has s ally appeared `
herein by
Dec M 2015125785,OR BK 17196 Page 755, himso erself.an amrms thaIsland amantsand deGared ns herein •.,1
Number Pages:1 are Yue and accurate g
Recorded O6I=15 at 03:48 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL g.m
COUNTY u
RECORDING$1000
Notary Public at re5County
My commisaion el(p1 : [e or c••.
Personally Known a`$
P,cduced identification $
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233 /�
Office(904)247-5/826 Fax(904)247-5845
Job Address: Permit Number:
Legal Description 351- S ates Parcel# 170476-QOM
Foor of—S t. 8 Sq.Ft
/2
Valuation of Work$ SL4dJ°` Proposed Work heated/cooled {�� non-heated/cooled 2-WI
Class of Work(circle one): New Addition Repair Demolition pool/spa window/door
Use of eaisting/proposed.structure(s)((rarcle one):, Commercial
If an existing structure,is a fire s rinkler system.installed?(Circle one): Yes No N/A
Florida Product Approval# L!a/Z -
For multiple products use product approval form f'
Describe in detail the type of work tolbe//performed:
Property Owner Information: �Ac/e/r�U�h/ SS
Name:��l��in�-YK'c ��/Yl! exey� Address: 39.$��:i
City r�A!�L. /<kb State FLZio I21-fJ Phone 3C L- s y 9 y
E-Mail or Fax#(Optional)
Contractor Informatio(n(��: pp /
C� Name: 9612 F' l), Qualifying Agen�t: prlta.lG.a mrarrc
Addre 20: r n./.e °-'.�'7 City /Ya State�Zip .?2�>?
Office Phone.5r/r- Ilfl Job Site/Contact Number 3'82-ry-P/ Fez#
State Certification/Registration# GCC— / f L7II6Y
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Leader Name and Address
Application is hereby made to obtain a permit m do the work and Imeallatlans as i eitcamd. I certify that no work m installation has commenced prior to the
usuanre o(a perm!!and that all work will be performedto meet the standards ofall laws regulating construction to tmsjurtsdiction This permit becomes mull
and void, wwk is not commencedwithin sir(6)mmdu,or ifconswclion w wok is suspended cr abardmedfm a yenodofsu/6)months at any time ager
work u commenced I understand that separate permts must be secwed for Electric Work, Plumbing,Signs, Wells,Pods, Furnaces,Boilers,Heelers,
ToNa omdAir Comdhioners,dc.
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.
Thereby ce dfy fiatl Mre read andemnimdtmslication artd know fie smneb be true and text(. Allprovtsiau� and mdirsmnces governing this
,gain ,work will be complied with whether sped ed hereto or not The grammg of a permit does not presume to an 'ry m violate m cancel the
provnaons zany otherfederal,state,or local law mgulutmg comhvctlon m fie performance iA
SignatureofOwn Signature of Cr
PrintName �/F *- „ 5 PrintName [lwn'
Sworn and subscribed efine a Sworn and subscribed ore me
this,,;/ Day of n 20 / this Day of - _ .20
otag c Notary i
' ._
='=1FjFt18.W
1.26.10
Vic Ff 18812➢ _EXPIRES.January l&2x19 �