469 ATLANTIC BLVD - ROOF PERMIT ;j y\Jc
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CITY OF ATLANTIC BEACH
MOE
K - ________,IY ATLANTIC 800 BEACH SE IN ,FLL 3223ROAD 3
INSPECTION PHONE LINE 247-5814
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ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
10B INFORMATION:
Job ID: 15-ROOF-1911
Job Type: ROOF PERMIT
Description: FL 2533 MODIFIED BITUM.
Estimated Value: $46.000.00
Issue Date: 8/11/2015
Expiration Date: 2/7/2016
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD
RE Number: 170690-0000
PROPERTY OWNER:
Name: DIAMOND REAL ESTATE PROPERTIES
Address: 6517 LOU DRIVE S
GENERAL CONTRACTOR INFORMATION:
Name: PRO JAX ROOFING, INC
Address: 1232 Wild Turkey CT
Phone: 904-570-4292
FEES:
BUILDING PERMIT FEE $280.00
STATE DCA SURCHARGE $4.20
STATE DBPR SURCHARGE $4.20
Total Payments: $288.40
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: 1/6 9 Arwri c L. Permit Number:
Legal Description 10-16 �l-tS-19 E SWAM Mc 3 Parcel#
Valuation of Work$ Y6 k Proposed Work he ted/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commer •. Residential
If an existing structure,is a fire sprinkler system ins : • s . ircle one): Yes No N/A
Florida Product Approval# F L 1.03
For multiple products use product approva arm
Describe in detail the type of work to be performed: fE-RCF
Property Owner Information:
Name: DtMiq,Jt7 K¢AA rsure poop c.nef 1V 11C Address: *15-/ - Vii, et. I.
City TAX State F(Zip 3v46 Phone (9o'r J /7l3-66 if
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: Pr 4Xro n
OJ j&ygaao,toi
Company Name: Ply TAX I FS"6• Qualifying Agent: LAANII Al- Pho ✓aC
Address: 1 Lit "iLd r4tty t r, City TAX State Pt
Office Phone (9°(v)33P-1�•i1. Job Site/Contact Number St"( Zip .71.1.-5Y
Fax#
State Certification/Registration# CCC 13Z83y3
Architect Name&Phone# Pfr
Engineer's Name&Phone# i IA
Fee Simple Title Holder Name and Address rAi
Bonding Company Name and Address
Mortgage Lender Name and Address ��
andApplication is hereby made to obtain a permit to do the work and installations as indicated. I certifil that no work or installation has commenced prior to the
void�wpermit i ot commenced w thin six(6)�monthst omeet construction ror work is suregulating enn r abandoned for apperiod jurisdiction. months atrany time aver
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.
I
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 cert that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
type ofwork will be complied with whether specified herein or not. The granting of a permit does not presume to give author' to violate or cancel the
7rovisions of any other federal,state, or local law regulating construction or the performanc of c st ct' n.
FU`�Pi3-rll —31 g
3ignahue of Owner Ali_ 14 ,,/ _- _ Signature of Contractor
'pint Name yy) ' 1 -�- a
/...l...f..i...e!/f k&.�- ! R.D.I�,d(..Q G..t S Print Name 1 A~r huveA L
3eforp me Befo e
'iis 1 Day of �}U e-v T ,20 /.0 this I I ' D • • •I S
SHERRI W PROVENCAL r; J. I, • I•i l�(
rotary
Aim' id / '..,w`¢' �i 1:.6—#;;;:;14.‘ e h ,��
Public is ` MY�OMNftSSION FF036324 ■ ' ,a,M'1
*�?ado.• EXPIRES July 15.2017 Bonded Thru Notary Public UndenWkers
(407)398-0153 FblklallotaryScrvice.corn
Revised 01.26.10
NOTICE OF' COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of FLoPia4- County of OK-
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: /0 It if_Z s-24 E'
5/11-7-11-14 Src s .
Address of property being improved: yd 9 Arapfi c KL.
4m'wn c BU! FL Az33
General description of improvements: l2E_RAF
Owner 6/AAof16 / 4L gfrATL P.qc,-nc-S IV L4.6 •
Address 4r14 Lou ,fit, S Xte FL, ALL/G
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor PP At/ / P/,'6
Address Tim ay LT- . FL 31-2-1'5
Phone No. 338-!}z1
Fax No.
Surety(if any) 1/04
Address Amount of bond $
Phone No.
Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name A,j�
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 /4
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 ^ fr
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
Slgned: ,ATE 7-6 6 -f S
Doc#2015183979,OR BK 17264 Page 1508, Before me this day of 'lA ' j
Number Pages:1 County of Duval, to o[,Flor d ha pgrsonally appeared in the
Recorded 08/11/2015 at 11:45 AM, J�tm J K JttM }N
Ronnie Fussell CLERK CIRCUIT COURT DUVAL himself/herself and affirms that all stateme herein by
.
COUNTY are true and accurate �
RECORDING$10.00
SHERRI W PROVENCAL
MY COMMISSION#FF036324
U', F,eH ' .",Zoi.F"• EXPIRES July 15.2017
{ (407)398.0153 FlorldallotaryService.corn
C
•
Notary Public at Large,State of u , County of 1.4 Ela
My commission expires:
Personally Known
or
Produced Identification