1975 Beach Ave 2013 roof (2) CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
!� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002318 Date 3/14/13
Property Address . . . . . . 1975 BEACH AVE
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 15000
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Application desc
REROOF
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Owner Contractor
------------------------ ------------------------
ARTHUR ANN W TRUST SCOTT WATERPROOFING INC.
PO BOX 331021 P 0 BOX 1748
ATLANTIC BEACH FL 322333313 ORANGE PARK FL 32067
(904) 781-1087
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Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 15000
Expiration Date . . 9/10/13
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 129 . 00 129 . 00 . 00 . 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: '17S 4-,,e 44I.-ir t B`"`A► F I 3 2 Z3 3 Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. q. t
Valuation of Work$ IS,ee e,c c Proposed Work heated/cooled . co non-heated/cooled
Class of Work(circle one): New Addition Alteration �RepairMove Demolition poot/spa window/door
Use of existing/proposed structure(s) (circle one): Commercialeside
If an existing structure,is a fire sprinkler system installed? (Circle one): es Ni N/
Florida Product Approval#
For multiple products use product apli—roval form
Describe in detail the type of work to be performed: t Cce -4 f 4s f"!jr roe
Property Owner Information:
Name: Awvi W Ar--A-r V41 Address: 19 7 r
City INt c r1_(k. w-1 State (Zip 1 .2_13.r Phone 9r,t( -),q 9 - -71`
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: St c-+4- W,'4i 61,f Y Qualifying Agent:
Address: Qe 66 )L 1-74 r City b`c•-,c State Zip Zia 7
Office Phone 19t,+Ti1-10 7 Job Site/Contact Number yc tj•-7 c S--190-7 Fax#
State Certification/Registration#
Architect Name&Phone# A&
Engineer's Name&Phone# /-
Fee Simple Title Holder Name and Address -D
Bonding Company Name and Address .4
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 thpis jurisdiction. This permit becomes null
and work er
void
sc o�imenced.not Icommenced within six understand that separate permits mor ut be secuconstruction
red for Electrical Work,Plumbing,Signs,aWells,Pools,eriod xFurnaces,Boilers,months tHeaters,
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 BEOMENTRECORDING YOUR NOTICE OF
COMMEI herebycertify that I 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 ork will be complied with whether sppeci zed 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[aw regulating construction or the performance of construction. II
Signature of Owner � Signature of Contractor
nn.� Print Name _ K �d...........................................................................
� � ..... �..................... . .
Print Name ��.k.+- .;.. .%� .....-... ..... +`............................. ..................................
Befor 2 Befor �C� 20 3
this Day of �� 20 J this Da f _
tr, ' ,, SHIRLEY L.GRAHAM
;�_ No ary Public EXPIRES:February 14,2014
Notary Public _ My r,UUfJMI$sICN DD 957760 ;I P�• � nded Thr Notary Public Underwriters
EXPIRES:February 14,2014TKUYISCIal2
®ended Thtu Notary Public Underwriters
MAR-14-2013 11:43 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/1
NCTIM OF COMENCEAMNT
pper/ (PREPARE W D11Al.1DATE
Permit No. 4 0 0 0 ;43J O Tax Folio No i 4 9.3 AI
Slate of County of '""j
To whom It may concern_
The undersigned hereby Informs you that improvements Will be made to certain real property,and in
accordanee with Section 713 of the Florida Statutes,the following information is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: df'rf, Iwo f✓o.l ds •��•�:�
n y t�• C �ti�,�.t y�� 3Ix33
dd�ss at prsperty being improved:
General description of improvements: +�eT—` Y`SwC¢
Owner AY\
Address l ,o �6 Ait�n&—JLkd Ei 3LLj.�
Owner's interest ill site of the improvement
Fee Simple Titleholder(it other than owner)
[dame
Address
Contractor
Addressk�fZs�S- � fa�+nC �Gf f C,-7
Phone No. 9��' 7?;- 10" Fax No._ 109 - 7' J' -O (t{ --
Surety(it any) /
) t N 1 N
Adoress Amovnt of band$
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 thaw)hlmself,designated by owner upon whom notices or other
documents may be served:
Name _ L21 A-
Address
Phone No- Fax No•
In addition to himself,owner deSlgnateS IM 1`0110"ng person 10 reeeiv2 41 Copy of the Lienors NOtIce as provided in
Sactlon 713.06(2)(b),Ftorlda Statutes.(Fill In at Owner's option).
Name
Address
Phone No, Fax No.
Expiration date of Notice of Commencement(the expiration Bate is one(1)year from the date of recording unless a
different date is specified).
THf8 SPACE FOR RECORDER'S USE ONLY A N�,� t,,y.W2A-1'^OANtcR 4 au..5+
P ca
13ef ora fne this day of !'L in the
CC��uuaaty of DVVtA, tM of A rlo pemonarly appeared
h�rgelff herself and affirms)hat an sratementg and deal.filiom,Korvin
are true and acrunte
Doc#2013065813,OR BK 162°0 Page 495,
Number Pages: 1 �y
ppcorded 03/144701:3 at 12-15 PM, Notary PutmN at mcomrnn Largo,stat or County of
P.onnle Fussell CLERK CIRCUIT COURT DUVAL PemomoyKKnn-;n X °C
COUN-ty Produced Idemlflcatlon --
FRFCOR01NG$10.00