1416 JASMINE ST - ROOF PERMIT `Y ,.k • `1, CITY OF ATLANTIC BEACH
1-1 y , „ f,-)
800 SEMINOLE ROAD
j 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-2299
Job Type: ROOF PERMIT
Description: reroof
Estimated Value: $7,800.00
Issue Date: 9/30/2015
Expiration Date: 3/28/2016
PROPERTY ADDRESS:
Address: 1416 JASMINE ST
I
RE Number: 171081-0070
PROPERTY OWNER:
Name: MARSHALL JR. CHRISTOPHER J
Address: 1416 JASMINE ST
0 GENERAL CONTRACTOR INFORMATION:
Name: A-Z ROOFING INC (ROOFING)
Address: 1032 W EDGEWOOD AVE QA ETHELYN KAY ROSEBORO
Phone: - -
FEES:
BUILDING PERMIT FEE $89.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $93.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: I LI I LP Jain iCf h, _ �J'2233 Permit Number:
Legal Description Pl-1-1 eih sec. 44 c+ 1 3[1e---2. -) Parcel # I I OS I — D7O
r� Floor ea of q.Ft. Sq.lit
Valuation of Work$ l � Proposed Work heated/cooled 13`1'% non-heated/cooled I cl l
Class of Work(circle one): New Addition Alteration Repair Move Demolition pooUspa window/door
Use of existing/proposed structures)) (circle one): Commercial Residential
i
If an existing structure, is a fir sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # [L 700(0 ,
For multiple products use product approval form
Describe in detail the type of work to be performed: 7 4 0 FF RE P0+7"
Property Owner Information:
Name: A r h • " •f,1r .&t at• • L Address: 11'4 D 2ept" SE .
City euittaiff. i State Ft Zip 3D Phone q0`1• 2Ll I • Iglo7
E-Mail or F.x#(Optional)
Contractor Information:
Company Name: A-2 r c Qualifying Agent: fie'1 y n 'o�rO
Address: SO I � � � City �C1V► State FL. Zip X22
Li ��� Y�� !_lam P 1?)
Office PhonegC 4•`1 lotp . L-4O10 'ob Site/Contact N �}ber qQi.-1 . Q 10 • '2-2-22-Fax#
State Certification/Registration# �- C- i 3 Z 33 7
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 penod of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Phunbing, Signs, Wells, Pools, Furnaces, Boilers,healers,
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 I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
d
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.
Ii
' V
/ �
kkAY0
Si nature of Owner Signature re f Contractor
Print Name e IINc>u - 3 W Print Name 07091 1 ,0,i(26 n J
Sworn to and subscribed before mc� Sworn to and subscribed before me
this O Day ofy�( IY�Cb'e__ , 20 in this .b Day o — •m.- >,a zza... 20
Alb.illairala 111111111111Th_ II'
Notary ubli Notary Pu. 1c — �
r • . 1 .26.10
9 ,,- MICHELLE OLESZEK r�`'���`°( ;, MICHELLE OLESZEK
k.
MY COMMISSION#FF058766 1E110 MY COMMISSION#FF058766
•,.':<•,,,0.?!.,' EXPIRES September 30.at
1 •., •if EXPIRES September 30.2017
,1071 308 0153 FloridallotaryService.com ■■toi)398-0153 FloridallotaryService.com
NOTICE OF COMMENCEMENT
:PREPARE IN DUPLICATE,
Permit No. Tax Folio No.
State of • c.RI,V A� County of prrr VA
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. II ,�.,, 7
Legal description of pro.-rty being improved:L---U"- /� (� i�� 7 SeC�M " f
4_.$ C G _ . • - 1
1 S• _ Gar.• 1 !• � — . e_si I vcJ
Address of property being improved: t 1"y t
ly Ito amine la-nfic 13-each F L "5Ga�3
General description of improvements: Z 0173 4 gue fzCi.%F
f�c l �— Art _SJ 61 NI&- R c p i rz
owner FChipe-1a qb IrrAmob i 11 e >, LLa
Address I1�(7 2LYt ' 5+- �1. �C r1Vi11P 15ch, PL X22 D
Owner's interest in site of the improvement O\AJ 11'10: 2—
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor P‘- Z_ ell :t —i.
Addressi--}5 �_rl ( • V 111 Q F L 3221
Phone NoQ01-1.lLoIo•1-4Dr0 Fax No.
Surety(if any
Address Amount of bond S
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 i21(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 t1)year fro; I a date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY ( & riorwNER
Signed: i
� DAT- 0 IJ�
Before = !:P!�:"day of 2C7 tie
Doc#2015224257,OR BK 17319 Page 932.
County of Duval.State of Fonda.has pi'er w appeared
��-_Lts Herein h;
Number Pages:1 himself. herself a affirms that all statements and d
Recorded 09/30(2015 at 02:45 PM, are true and accurate
Ronnie Fussell CLERK CIRCUIT COURT DUVAL *.
.
A. •, . MICHELLE OLESZEK
COUNTY MY COMMISSION*FF058766
RECORDING 51000 .
� Fa EXPIRES September 30,2017
Notary Publica arge. tat of_ {_ ot,I •
My commission expi,es4,
Personally Kna•n _ _ or
Produced Identification