265 MAGNOLIA ST - ROOF (--
CITY OF ATLANTIC BEACH
r- f 800 SEMINOLE ROAD
j ;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'�J.31 J~
ROOF PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ROOF-2469
Job Type: ROOF PERMIT
Description: REROOF FL10674 R10
Estimated Value:
Issue Date: 10/19/2015
Expiration Date: 4/16/2016
PROPERTY ADDRESS:
Address: 265 MAGNOLIA ST
RE Number: 170543-0000
PROPERTY OWNER:
Name: SMITH TRUST, PAMELA A
Address: 265 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: ROGERO & WILLIAMS ROOFING CONTRACTORS INC
Address: 883 Lawhon Dr ST
Phone: - -
FEES:
BUILDING PERMIT FEE $102.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
•
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904)247-5845
Job Address: 2(06 may() jct. &-(- R+!c rrH h R Permit Number:
Legal Description lb- 1(a �S —age 6. 90. 3
Floor Area o Sbe1~'t� Parcel# ( 00er)
Valuation of Work$ f I6)0.60 Proposed Work heated/cooled 191 i non-heated/cooled r1
Class of Work(circle one): ew Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed? (Circle one ryes o N/A
Florida Product Approval# 1
For multiple products use product approval appreT,Tirforn
Describe in detail the type of work to be performed: re.r'oo-F ' hi rode_
P
Property Owner Information:
Name: P(,1rnOlQ sVV11111 a(0�
Address: (M ctak n n I I, a_ 5+r e e�
City Att } a)Np,c1/l StateQ,Zip _C33 Phone Reg- • 477 • c��
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: f w Co f
,� r, 00 CO)yc
Company Name: 1,...& • - Ili ter. L.i Qualifying Agent: Jere
Address: 9 gO k{ 41 e 'a' Oa- O
Office Phone Kb 4. R � Co3 Job Site/Contact Numberlty�/c k 4 o but 11 e tate F Zip z
State Certification/Registration# CCL j 3 jQ3 g 111ce�K 53l�- S$77 Fax# ojpef • WC/ • �cfpa
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 cert 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 f 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. I 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 LENDE ' OR AN AT • ' Y BEFORE RECORDING YOUR NOTICE OF
OMMENCEMENT.
I hereby certify that I have rear and•xamin t s a.pli a o and kn the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complier wit whets•r s.ec red e • n or not The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other feller•1,s te, or oca • regulat g co 1strr t' n or the performance of construction.
Signature of Owners ( -
Signature of Contractor
'rint Name Q.vn e\& Print Name JP/
3efore me Before me
zis Day of / ,-t/ j ' tl is IY Da •
#FF2t8'eg 1 - ELBA g 20f�'
d4 ` �.. f „sokhb, pAV • D..�,naFF2gi�.
Total P .Tic so nvm .aa �11
y s.�i : Mr 11 gi� 2e�� _ • ��� 'Lli�, ., omm�ss�• O ..
Apftt y Ai�t _s _. .._� Yr� , 2 19
Revised 01.26.10
Doc # 2015236923, OR BK 17336 Page 420, Number Pages: 1, Recorded 10/15/2015
at 08:52 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
NOTICE OF COMMENCEMENT
!PRefAne IN OWLIIAre,
Pe nrt No. _-� 7sx Faso No.
State d FLCO.D. County of
To whom It may concern:
The undersigned hereby Informs you that improvements wel be made to certain real property,and In
accordance with Section 713 of the Florida Statutes.the following tMermatton Is stated In tills NOTICE OF
COMMENCEMENT
�/ r r'
Legal deSSripl.on d property ban„lmprovrd. 'U 1( . __ C..�
Regress Of progeny being improved' I rtc t i cs, .j'
_.......... Vita Y ;t' ;i :cx_ci i ,fi 3' "7i__._._
Grnerer description or anprovemen:s r 6_,..0 :1>C3S —..._ —.
Owner . f .. t~.. ` t .. �g...�...r..
AWiiess �.(& O.et i • • M'e. `.�tatR►K\'Ii f G�7. Ft
Omar''nlereM r We of ma bnplovaxnt a i :L• )€r: 'y"a
Fee Simple Titleholder iii pine,Ivan owner),,,„__ _
Nane ROGERO MD witaoRIB bu1Lowo AM>ROOFING CONTRACTORS —.._
Add. NAATLEY ROM/SUM 02 IACKXMYI►F.FLORIDA 32777 _.
Convected JEREMY S ROGERO
Acidic,'2980 NARILEY ROAD.SOME e2 MCKSONNLII FLORIDA 32257
Phone No.944•518'54e3 Far No.904614.24(10
Surely id any)
Address Amount of bond i ...
Phone Na. ._, Fax Ne
Name and address of any person mailing a ban for the r ornbucb on el the Eftosevements.
Name
Adtkett
Phone Nn Fax No _.---- �-
Name of person wr'ren the Stale of Flows:other than nurse••destonatea by ownet upon whoa.fences or other
documeMS may WI tented
Name .1EREMEr S ROOERO
Addtasa 2980 HAR'TLEY ROAD SUITE 12 JACKSONVILLE FLORIDA 32257 "--
Phone No *04 5tes43 Fez No.904-619-2400
In odd''hoe to himself.owner designates lbe lolowmg person to receive a copy of the hand's Notice as provided In
Section T13.06 t2)tbt.FRortda Staines.IF I in at Owner's opuoni.
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