1670 BEACH AVE - ROOF PERMIT S' - 7,
- r
r ��V' CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
.- ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
<----056911'
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-ROOF-1725
Job Type: ROOF PERMIT
Description: REROOF FL 1956.3
Estimated Value: $12,255.00
Issue Date: 7/20/2015
Expiration Date: __1/1.6/2016
PROPERTY ADDRESS:
Address: 1670 BEACH AVE
RE Number: 169570-0000
PROPERTY OWNER:
Name: ESHELMAN. THADDEUS 0
Address: 1670 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: B. SMITH ROOFING. INC.
Address: 13525 SAWPIT RD QA SMITH. BRIAN EUGENE
Phone: - -
FEES:
BUILDING PERMIT FEE $111.28
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $115.28
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904)247-5845
Job Address: t 00 &Ar-k R` Permit Number:
Legal Description IS- Oci-a5'>9 E p.134 Occn,.�6►� O o+ `5 (e�6
sto �Ili Parcel#
Floor Area of Sq.Ft. Sq.F't
Valuation of Work$ la1155.00 Proposed Work heated/cooled 1839 non-heated/cooled 42C15
Class of Work(circle one): New Addition Alteration Repair Move Di
pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial 1'esidenti.
If an existing structure,is a fire sprinkler system installed? (Circle one): 'es No /A
Florida Product Approval# 195(..3
For multiple products use product approval orm
Describe in detail the type of work to be performed: Dy-Poi 30 ssatmKS s h)rv-1,.. 914 v.310pe
Property Owner Information:
Name:'t{-,addeus 0 Es1,cIn,14 r4 Address: 1010 Bend-. 1 c
City MI farst,e. P)eod, State&Zip 32443 Phone 'to i- bo'1-3195
E-Mail or Fax#(Optional) wi A
Contractor Information: CONTRACTOR EMAIL ADDRESS: b5n„31,Qun•F,,,60 p-1•+.net-
Company Name: (3-Ser.46 Ro3Ain4).1r-tc. Qualifying Agent: 4�rrpn E. Sn.•{ ■
Address: t35m 5o4:4 P City Sax State A. Zip 3s3sC
Office Phone clou-Ilt-SCPS Job Site/Contact Number gb'+-3,1e Sf60r Fax# cloy-3-rS•Y604
State Certification/Registration# 13-1-011A.
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 cert/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 f 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'York,Plumbing,Signs, Wells,Pools, Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc. r
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.
I hereby certj that I have read and examined thisplication 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 give 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 ::�/'�`cc..06 ‘14 Signature of Contractor i"--- —""'"'"
Print Name 1/-roJ1,e4 0. ;She/up' Print Name ,Bnn. FS..A
B�,'� Before me
LI/ Lip'
D, of 7�y ,20 [5 th'. ;fir �'yL�� 20
AP !".....__ Ida ek.W AIL
f!►%rs 'll IC 46‘,....et. ANGELA J.NEWNWI O r u lc'�i// ^r' c
* _� ,k MY COMMISSION t FF 109944 '!' * 'ISSIONttt��FF��1ff0118��944
T EXPIRES:April 25,2018 .> ' •o '1 :'luf 4,•Nob QeNkri
`'+rE.a ro/r Bonded Thru Budget Notary Services 44.000. ''
NOTICE OF COMMENCEMENT
State of County of Tax Folio No.
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: 15-173A pq 1: p.13(, ncc ar 6t0•4 c Or'4 ►O 1 5`O
rots 1'5 Rik6
Address of property being improved: 16 10 (Vgrk,
General description of improvements: 30;,,t,•ptr3 31-1,nAL-5
Owner: 'Tin P,t4 , p ,dn,a;, Address: IC7
t3e�t, AN c. &nl�,FL. 3X2-33
Owner's interest in site of the improvement: s';
Fee Simple Titleholder(if other than owner):• rn S
�i o
Name: v
Contractor: R. 5,,,u„ ap 8
Address: 135A...5 5r4u' `1 P4 5(% FL
tr
Telephone No.:q014-3-746 -gco5 Fax No: �'w S
yDU-3 -��b�
Surety(if any) U o�_
N N o
Address: 'n ° z
Amount of Bond$ �°-g
Telephone No: Fax No: z
8 = 8 o O w
orcrcom
Name and address of any person making a loan for the construction of the improvements z
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:
. 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)(b),Florida Statues. (Fill in at Owner's option)
Name:
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: e)Z e-oal-'
�`:,":•°.:'°�% ANGELA J.NEWMAN Before me this 2O day of '• Date: -2/y ofS
MY COMMISSION#FF 108944 y :rots/.! in the County of Duval,State
* Of Florida,has personally 'eared ';Th.! _ ,
i7 EXPIRES:April 25,2018 Personally Kno • / �' / A'�/
Jr�tfOFPIpP`or Bonded ru Budget Notary Services Produced Id:
�rr or
Notary Publi _Ate �
My commissio_Ate AVM.la Aria. W
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