1770 E PARK TER - RE-ROOF „' '` �S\ 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-1937
Job Type: ROOF PERMIT
Description: REROOF FL10674.1
Estimated Value: $11,841.00
Issue Date: 8/13/2015
Expiration Date: 2/9/2016
PROPERTY ADDRESS:
Address: 1770 E PARK TER
RE Number: 172020-0386
PROPERTY OWNER:
Name: ANDERSON JR.DYAARL L & CLAUDIA, *
Address: 1738 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: BIG FISH ROOFING INC
Address: 6821 N SOUTHPOINT DR APT 114 STEVEN SCOATES
Phone: - -
FEES:
BUILDING PERMIT FEE $109.21
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $113.21
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: % ' O- / 7,;,(-are QS�J AB Permit Number:
Legal Description—X50 f'•-25-Z9f /f&iina, um f 9 Parcel # /7Z070- 03S-47
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S //) gy1 Proposed Work heated/cooled Z oce non-heated/cooled
Class of Work(circle one): ew Addition Alteration Repair Mov emolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residen •
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N /A
Florida Product Approval # Jb( 7C/, I
For multiple products use product approval form n
Describe in detail the type of work to be performed: ge f�(ot'
Property Owner Information: � 7
Name:J /'6/l t � y 1, A €s—on Address: /�/e7 )°sr f k /Cf.1QGe- J S1
City . /2c, / Staten-Zip.3„233 Phone a '51/v
E-Mail or Fax#(Optional)
Contractor Information: /
Company Name:i � J • . 11 Quali i ig Agent: Skye/7 ScoakS
Address: r, .aiffA7 � i e City „aCtsupiu (/. State F'L Zip
Office Phone 0Y-(a. . -r?3 3 y Job Site/Contact Number Fax 11
State Certification/Registration# ( G!3 30(/''(
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 nub
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for apperiod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for ElectricalWork,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
r ■ • ' a ' ' N ATTORNEY BEFORE RECORD . • • : = — - •
!�'irs STACY SIMMONS COMMENCEMENT. ;�� "•r ` ONs
s•• �• ::: Commission#FF 098012
•••7 Commission#FF 098012 Expires March 3,2018
I here. «.,:�� �> t• ''.F `�:5• •h.��'• • ;{d is application and know the same to be true and correct. Al r3411 :33s o4Jtrw'tar#e+oridti+aa+aeoerBsgayr''rring thi;
type o b ' • :tl # ihuii 4mn - ,ci red herein or not. The granting of a permit does not p •sunre wa-gR2zn ncel the
provisi. ' . •r e.era, sta e, or oca aw regulating construction or the performance of construction.
Signature of Owner Q( Signature of Contractor r
Print Name .0 I . , cr Print Name s(i er) 5CQCI c'5 # Cc.. ,30w
�� Before me
Before Day of OUitt—�–7 L , 20 /S this Day of �Gl iy5.1– ,20 /S
. acs SU4t,1n7,K-41 - ,J '(
Notary Pui is Notary Pv 1flc
Revised 10.24.12
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No. //��
State of I ( County of /./tli%/
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. ( /� C
Legal description of property being improved: e✓' C) - Z J 29
Address of property being impro ed: .� 7 , C' Par/' 7'lp"6C-,
eacA7 t=C 3 Z Z 33
General description of improvements: "reel'
•
// /
Owner //IL /Y'yi.C1.-S 6h
Address /770 /'Guff. " e'.'ra.'race ea5 A An-17c /3e e/ /-7'C 32z f
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor ,4s
c ;4 y
Address C Z( v• /
V,,/(C• 3 _z/ .
Phone No. 'D V_ 6 e
Fax No.
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 • N. '•'1„;,,.•'
Signed. DATE x
Before me this day o OA /in the 12.
n
ounry o(.• .1.State of Florida.has.. , ally appeared `cR
Dec#2015184936, OR BK 17265 Page 2151, YOGI r=\r�P� 5. herein by y co
Number Pages: 1 himself/herse and affirms that all statements and declarations herein s.
2"2
Recorded 08i1015 at 09:48 AM, are true and accurate °.
T G
Ronnie Fussell CLERK CIRCUIT COURT DUVAL n ,, W
COUNTY
RECORDING$10.00
Notary Public at Large.State of County of U1,i 110 ' o
My commission expires: ' - 1
Personally Known or
Produced Identification f l / .