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1010 CAMELIA ST - RE-ROOF S rLy firI 64 'r . 11r� CITY OF ATLANTIC BEACH `N ' I j 800 SEMINOLE ROAD J , z.: = 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-2156 Job Type: ROOF PERMIT Description: RE-ROOF - SHINGLES Estimated Value: $5,288.00 Issue Date: 9/11/2015 Expiration Date: 3/9/2016 PROPERTY ADDRESS: Address: 1010 CAMELIA ST RE Number: 170992-0030 PROPERTY OWNER: Name: SCHLENORR, ROBERT Address: 1094 STOCKS ST GENERAL CONTRACTOR INFORMATION: Name: QUALITY DISCOUNT ROOFING LLC Address: 1794 ROGERO RD QA RICHARD BRIGGS Phone: - - FEES: BUILDING PERMIT FEE $76.44 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $80.44 PERMIT IS APPROVED ONLY IN ACCORDANCE WVITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIIE 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 I S-- RO© R - Z 15 (c' Job Address: 1010 Camelia St.Atlantic Beach,FL.32233 Permit Number: Legal Description 18-34 17-2S-29E SEC H ATLANTIC BEACH Parcel#170992-0030 Floor Area of Sq.Ft. Sq.Ft Valuation of Work$5.288.00 Proposed Work heated/cooled 1007 non-heated/cooled 1353 Class of Work(circle one): New Addition Alteration ice- Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial 4'eside If an existing structure,is a fire sprinkler system installed?(Circle one): 'es No Florida Product Approval#FL-7006.1 For multiple products use product approval form Describe in detail the type of work to be performed:Remove 1 layer down to roof deck.Re-nail deck per code.Replace with IKO Architectural Shingles 21 squares FL-7006.1 ,pt y,,,, ei//arivo 4o,yte4 4;04,,,vf IL -i5,ay4 Property Owner Information: Name: Helia Adelino Address:1010 Camelia St. City Atlantic Beach State FL Zip 32233 Phone 603-264-3930 E-Mail or Fax#(Optional) Contractor Information: Company Name:Quality Discount Roofing LLC. Qualifying Agent:Roger Zeigler Address:3481 St.Augustine Rd.City Jacksonville State FL Zip 32207 Office Phone 904-396-5000 Job Site/Contact Number Fax#_866-329-6692 State Certification/Registration# CCC 1329885 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. l 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. I hereby certify that!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 give authority to violate or cancel the provisions of any other federal,state,or local taw re lating construction or the performance of construction. Signature of Owner 9deliti_ - Signature of Contractor Print Name HE L/L Y'.........j¢L//'nv............ Print Name .............. Sworn to and subscribed fore a Sworn to and subscribed before me this A Day of Lnyl, .20 f c' this Q?'Day of 5 be,c ,20 IS No C 0�� ���� llotublre 1' 0-€1-A Revised 01.26.10 HII1 SHEREE J.CARUSOry Public-State of Florida ommission FF 227615 omm.Expires May 5,2019 alNotar Assn ed through Nation y ( °, cF.' Bonded through National Notary Assn. • Doc # 2015208330, OR BK 17297 Page 2340, Number Pages: 1, Recorded 09/10/2015 at 01 :46 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 NOTICE OF COMMENCEMENT (PRePAea in Ot.%t.!CASY:) Permit No. Tax Folio No. 170992-0030 State of FLORtOA County of DUVAL. — To whom It may concern: The undersigned hereby informs you that improvements will be made to certain real property,and In accordance with$ecIIOri 713 of the Florida Statutes,.the following information Is stated In this NOTICE OF . COMMENCEMENT. L.egat desonpt?on of property being Improved: 18-34 17-2S-29E SEC H ATLANTIC BEACH Address of property being improved: 1010 CAMELIA ST ATLANTIC'BEACH, FL 32233 • General description of improvements! t"`ke, r • Owner HEUA ADELINO Addres0010 CAMELIA ST ATLANTIC BEACH.FL 32233 Owner's interest in site of the improvement :l Fee Simple Titlehcider(if other than owner) • _ Name i Address F t Contrac tar QUALITY DISCOUNT ROOFING L LC. Address 3481 ST.AUGUSTiNE RD.JACKSONVILLE,IL.32207 Phone No.,X4-396-.500 Fax No. 86.6.329.6692 Surely(if any ;?,.; , ---- . — Address Amount of bond 3 Phone No. -,Fax No. _......__ I Name and address of any person making a loan for tho construction of the improvements Name —.... ._.tai :t>.. Address Phone No. Fax No. Name of person within the State of Florida,other than himseif,designated by owner upon whom notices or other documents may be served: Name Address -- I Phone No._,,.,_ _ . . Fax No In addition to himself.owner designates the following person to receive a copy of the Lieno!'s Notice as provided in Section 713.06(2)(b).Florida Statutes.(Fit in at Owner's option). Name Address Phone No._ ----------•-•----Fax Nn. Expiration date of Notice of Conin'encetneft(the expiration date is one(1)year front the date of recording unless a ?4,11 sdifferent date is specified): i so, .,, THIS SPACE FOR RECORDER'S USE ONLY r ;r) at j)OWNER ( ,,,, ,�'P } atvwd: it 'tx ('k. t (4'.- tE+.. p t�1t.s�' 3 1A r open by t+ittaa me Uvs c"�?v day of.. : :.%:&.;;a'<—\,:SA, —lit iii `� o j C^�tyof t]uva!,::late of Fprlie,haiPetsona9r aapttxe :3`•c 0$ 1 wse!t'trstt.raad affim»that ap statements and dociar s horoin , r• v �!► .. 'r. eta ire,ayM accurate Ti ' °� °oo t i <, f It `�' �� r7i `,....xa+� :tom:_a....:.'�., rlE.h`.• !x 1�' .... w j T 4 (My co ut,za!ia ta.£}tAtiof 4r:: � r,^�LU<,l a Porsoittit4tC`ReAQ:r�a ct Pa:ondi`x lVY2Kr1-..---. ....... .s... _ .._.__tN r. ..