213 S NAUTICAL BLVD - ROOF PERMIT LAN-.,,„
of � - ° , CITY OF ATLANTIC BEACH
4 ' 800 SEMINOLE ROAD
5 w. r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'rt Jii1W>
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-1726
Job Type: ROOF PERMIT
Description: RE ROOF - SHINGLES
Estimated Value: $6,190.00
Issue Date: 7/20/2015
Expiration Date: 1/16/2016
PROPERTY ADDRESS:
Address: 213 S NAUTICAL BLVD
RE Number: 170703-0384
PROPERTY OWNER:
Name: CYNTHIA, COX
Address: 213 S NAUTICAL BLVD
GENERAL CONTRACTOR INFORMATION:
Name: B. SMITH ROOFING, INC.
Address: 13525 SAWPIT RD QA SMITH, BRIAN EUGENE
Ph one: - -
FEES:
BUILDING PERMIT FEE $80.95
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $84.95
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 1 S — R F _'7 Z co
Office (904) 247-5826 Fax(904) 247-5845
Job Address: oil 3 N .u4 cwt. (?I.ig S. PAI 1,c h,a• :3;u33 Permit Number:
Legal Description 35'04 ri-a5 -)y 5 Asp f0y L,oi-c1 BIK 4 Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 6190.00 Proposed Work heated/cooled 1400 non-heated/cooled Ira
2,e-Ro?
Class of Work(circle one): New Addition Alteration Repair Move pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial it- '•- •tial
i
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes o N/A
Florida Product Approval# I`1 C•3
For multiple products use product approval form
Describe in detail the type of work to be performed: P,e-Roo4 a5 5.c ,„s 5H0,.655
Property Owner Information:
Name: C-Yr likA 6• Co x Address: a.I3 N Ati*i c„L I N J Sak-^4h
City Aalch,A,c. State A. Zip 3,)..2-33 Phone Sou-30L+-O-1RI
E-Mail or Fax#(Optional) 1-11 P.
Contractor Information:
Company Name: B. 5m,1 -,9.00Ci 14, Ii,-,-4._ Qualifying Agent: BR,r..u. 5. Sn..lh
Address: 1)6).,!'”, e p to v k Qd City SAh. State FL• Zip 3J-?.?.
Office Phone c\0 k-3`1S--4s0 K Job Site/Contact Number 'oLI-Hu5.g 3'1$ Fax# 'loci-3`a-'i-
State Certification/Registration# 13a6F4 I a,
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 a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
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(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, 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 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to gyve authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner t Ce It( 6/1/G Signature of Contractor !f' f
Print Name .A• cy(4h,p, G. Cq,g Print Name '•' - F_. .u.4h
e . , ; an• subs ribed before orn t. . •: • : cribed before me
Da of 3�1 20�� is ,k�ls• ofd thiZJI y ,2015
alk�b► . c :• . c LAJ.NEWMAN Nota—,u■ * . . * • ISSIoNlFF 108944 ary * * MY COMMISSION t FF 108944 E P��prF ;I 5,2018
EXPIRES:April 25,2018 x+4.0 Iwo Services
rlote ,, Ar Bonded Thru Budget Noting Was
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
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: 3-5-0-1
,SE P.5KP
LOA f51104
Address of property being improved: C c.A 3 NA„-t',c
General description of improvements: P.c' ,: as Sh,tsc cs
Owner Cy l;,n G. Co'c
Address a 13 t.! :�i',c.FL cow . sc.nd^, 3€J-33
Owner's interest in site of the improvement Simple
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor B. Smith Roofing, Inc.
Address 13525 Sawpit Road Jacksonville, Florida 32226
Phone No. 904-378-8605 Fax No. 904-378-8606
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.
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: !it' CIJ7 /L.CL, P4(11, !/ - DATE 7/isJLS
Before me this 'j day of in the
County of Duval,State of Florida, has personally appeared
Cy^-14"" C. r.o)e herein by
himself,'herself and affirms that all statements and declarations herein
Doc#2015165686,OR BK 17239 Page 964, are true and accurate
Number Pages: 1 4o'.;`Y•.';'a(,,, ANGELA J.NEWMAN
Recorded 07/20/2015 at 11:30 AM, , MY COMMISSION#FF108944
Ronnie Fussell CLERK CIRCUIT COURT DUVAL 1 * . l_
COUNTY f TI• EXPIRES:April 25,2018
RECORDING$10.00 `� +rFOFF�o��° Bonded Thru Budget Notary Services
� i
My�ry Public. L-rge• S o [�J7S County of . 4V1 V
.: missi. expires: P rt 451 Sr .0 ba
Personally K .',vn
or
Produced Identification