Permit Roof 489 Aquatic 2011 rL`l•
,tell 'i, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s1
} ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002955 Date 12/01/11
Property Address . . . . . . 489 AQUATIC DR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3500
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Application desc
REROOF
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Owner Contractor
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TODD LARRY. GREAT WHITE CONSTRUCTION INC
2444 BENTWATER DR W 4320 DEERWOOD LAKE PWY
JACKSONVILLE FL 32246 JACKSONVILLE FL 32216
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Permit . . . . . . ROOF PERMIT
Additional desc . . REROOF
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3500
Expiration Date . . 5/29/12
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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 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 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: 489 V''L- 3z'z33 Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S 3 S'z)a Proposed Work heated/cooled 1'Zo6 non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(j)(circle one): Commercial Residential
If an existing structure,is a fire sprinkle installed?nstalled? (Circle one): Yes No N/A
Florida Product Approval# O /Z
For multiple products use product approvdl form
Describe in detail the type of work to be performed: -oa�-
S/lZ F� ( ►et��(.t4
Property Owner Information:
Name: Address: uSa't
City 1 kko-A-a-3 01% State VLZip 3 zZ i 3 Phone *c are 440-2
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: C-WC Qualifying Agent:_CY-C, % Sk u%'Liy-
Address: g3a61Dervt-cr4 l.c a u.. dlqo City 3Dr State fl- Zip32zt(
Office Phone qoq J3 ft-ll.,Sg JobSite/Contact Number Fax#
State Certification/Registration# CLf- 13 L9o57
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 inhas 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_peraod 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, urnaces,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.
1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authorityty violate or cancel the
provisions of any other federal,stat r local law regulatin construction or the performance of construction. Ft4x q Z 3P 3 7130 7 0
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�Signature of Owner =*: :*� DEBORAH AMA►� oW5Ha4s'i ature of ContractorEXPI �,1
t 4` Bonded hrRNot"Public Ur�tle 5
7.;
Print Name 61Ire, ............ .. ................. i Name Tir�siS....S�a ..................................................................
Sword subscr', e / fore me/ Sworn nd sub d bef rem
this ff Day of 20 //
thi ay of 20 ��
Notary Public NotaryDEBORAH AMANDAWHtTE
MY COMMISSION it EE 057349
a,= .EXPIRES May 21 nderwi se 01.26.10
7- 3
00 'S r '�J,pf 4� Bonded Thru Notary Public Undenv ie;
DEC-1-2011 11:08 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/1
NOTICE OF COMMENCEMENT I1.0195T
State of^ Tax Folio No.
County of lzm
To Whom it May Concern:
The undersigned hereby informs you that improvements will be made to mrtam real,property, and in accordance with section 71.3 of
the Florida,Statutes,the following information is stated iz1 this NOTICE OF CONIMENCWENT.
Legal.Description of property being improved:
Address of property being improved:
General descriptionof improvements:
Owtaer' I,. .'rr Address:
Owner's interest in site of the improvement: — — — —
Fee Simple Titleholder(if other than owner): Doc#201 1258B27,OR BK 15783 Page dgg,
Number Pages:1
Name:���� Recorded 12101/2011 at 10:24 AM,
JIM FULLER,CLERK CIRCUIT COURT DUVAL
C.ot7lractDT: � ^tfit. S COULTY
Address: Lia-0 T*tW=A RECORDNG$10.00
Telephone No.: ",j-3 fir•[45 Fax No:
eviur (if any)
Amount of Barad$
Address:
Tcicphone No: Fax No:—
Nanae and address of any person making a loam for the construction of the impravements
Name:
Address:
Photic 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:
Telephone No: Fax No:
In addition to bimsclt owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
71,3.06(2)(b),Florida Statues. (Fill in at OwnOt's option)
Name:
Address:
Telephone No: Fax No:
l✓xpiration date of Notice of Commencement(the expiration date is one(l)year from the date ofrecording unless a different date is
specifl.od):
'M.S SPACE FOR RECORD E WS USE ONLY OWNER
Signed: _ Datc: f
I
111
Before me this 6T' day of Zhe&..h- /f in the County of Duval,State
Of Florida,has personally appeared_ 4L
pEWWAMMOAI1 Notary Public at Large,Staic of Florida,County&Duva.
r myG MMW(N'tMt� MycominMoncxpiz ,
p(PIAES:May 21,0015 Pcrwually Known. G. ^ or
90 dTtfnfN PraNcUrwennN Producedidmtffication: P-t-0c
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